diff --git "a/docs.json" "b/docs.json" --- "a/docs.json" +++ "b/docs.json" @@ -201,7 +201,7 @@ ], [ "Bad Breath (Summary): Summary There are many reasons why you might have bad breath. You can get it if you don't brush and floss regularly. Bacteria that build up in your mouth and between your teeth produce the bad odor. Other problems in your mouth, such as gum disease, dry mouth, or cavities, may also cause it. Sinusitis or problems with your nose may be to blame. You can also have bad breath if you eat some foods, like raw onions, garlic, or cabbage. And of course smoking causes its own bad smell. Some diseases and medicines can cause a specific breath odor. Having good dental habits, like brushing and flossing regularly, help fight bad breath. Mouthwashes, mints or chewing gum may make your breath fresher. If you have a disease that causes the bad breath, treating the disease may help give you fresher breath.", - "#" + NaN ], [ "Bad breath (Symptoms): Bad breath odors vary, depending on the source or the underlying cause. Some people worry too much about their breath even though they have little or no mouth odor, while others have bad breath and don't know it. Because it's difficult to assess how your own breath smells, ask a close friend or relative to confirm your bad-breath questions. When to see a doctor If you have bad breath, review your oral hygiene habits. Try making lifestyle changes, such as brushing your teeth and tongue after eating, using dental floss, and drinking plenty of water. If your bad breath persists after making such changes, see your dentist. If your dentist suspects a more serious condition is causing your bad breath, he or she may refer you to a physician to find the cause of the odor.", @@ -229,7 +229,7 @@ ], [ "Pneumococcal Infections (Summary): Summary Pneumococci are a type of streptococcus bacteria. The bacteria spread through contact with people who are ill or by healthy people who carry the bacteria in the back of their nose. Pneumococcal infections can be mild or severe. The most common types of infections are - Ear infections - Sinus infections - Pneumonia - Sepsis - Meningitis How the diagnosis is made depends upon where the infection is. Your doctor will do a physical exam and health history. Possible tests may include blood, imaging, or lab tests. Treatment is with antibiotics. Vaccines can prevent pneumococcal infections. There are two vaccines. One is for infants and young children. The other is for people at high risk, including those who are over 65 years old, have chronic illnesses or weak immune systems, smoke, have asthma, or live in long-term care facilities. Centers for Disease Control and Prevention", - "#" + NaN ], [ "Diabetes (Treatment): Type 2 diabetes may be reversed with lifestyle changes, especially losing weight with exercise and by eating healthier foods. Some cases of type 2 diabetes can also be improved with weight loss surgery. There is no cure for type 1 diabetes. Treating either type 1 diabetes or type 2 diabetes involves medicines, diet, and exercise to control blood sugar level. Everyone with diabetes should receive proper education and support about the best ways to manage their diabetes. Ask your provider about seeing a diabetes nurse educator. Getting better control over your blood sugar, cholesterol, and blood pressure levels helps reduce the risk of kidney disease, eye disease, nervous system disease, heart attack, and stroke. To prevent diabetes complications, visit your provider at least 2 to 4 times a year. Talk about any problems you are having. Follow your provider's instructions on managing your diabetes.", @@ -253,7 +253,7 @@ ], [ "Macular Degeneration (Summary): Summary Macular degeneration, or age-related macular degeneration (AMD), is a leading cause of vision loss in Americans 60 and older. It is a disease that destroys your sharp, central vision. You need central vision to see objects clearly and to do tasks such as reading and driving. AMD affects the macula, the part of the eye that allows you to see fine detail. It does not hurt, but it causes cells in the macula to die. There are two types: wet and dry. Wet AMD happens when abnormal blood vessels grow under the macula. These new blood vessels often leak blood and fluid. Wet AMD damages the macula quickly. Blurred vision is a common early symptom. Dry AMD happens when the light-sensitive cells in the macula slowly break down. Your gradually lose your central vision. A common early symptom is that straight lines appear crooked. Regular comprehensive eye exams can detect macular degeneration before the disease causes vision loss. Treatment can slow vision loss. It does not restore vision. NIH: National Eye Institute", - "#" + NaN ], [ "What are the genetic changes related to Stargardt macular degeneration?: In most cases, Stargardt macular degeneration is caused by mutations in the ABCA4 gene. Less often, mutations in the ELOVL4 gene cause this condition. The ABCA4 and ELOVL4 genes provide instructions for making proteins that are found in light-sensing (photoreceptor) cells in the retina. The ABCA4 protein transports potentially toxic substances out of photoreceptor cells. These substances form after phototransduction, the process by which light entering the eye is converted into electrical signals that are transmitted to the brain. Mutations in the ABCA4 gene prevent the ABCA4 protein from removing toxic byproducts from photoreceptor cells. These toxic substances build up and form lipofuscin in the photoreceptor cells and the surrounding cells of the retina, eventually causing cell death. Loss of cells in the retina causes the progressive vision loss characteristic of Stargardt macular degeneration. The ELOVL4 protein plays a role in making a group of fats called very long-chain fatty acids. The ELOVL4 protein is primarily active (expressed) in the retina, but is also expressed in the brain and skin. The function of very long-chain fatty acids within the retina is unknown. Mutations in the ELOVL4 gene lead to the formation of ELOVL4 protein clumps (aggregates) that build up and may interfere with retinal cell functions, ultimately leading to cell death.", @@ -353,7 +353,7 @@ ], [ "Blood Clots (Summary): Summary Normally, if you get hurt, your body forms a blood clot to stop the bleeding. After the bleeding stops and healing takes place, your body usually breaks down and removes the clot. But some people get too many clots or their blood clots abnormally. Many conditions can cause the blood to clot too much or prevent blood clots from dissolving properly. Risk factors for excessive blood clotting include - Certain genetic disorders - Atherosclerosis - Diabetes - Atrial fibrillation - Overweight, obesity, and metabolic syndrome - Some medicines - Smoking - Staying in one position for a long time, such as being in the hospital or taking a long car or plane ride - Cancer and cancer treatments Blood clots can form in, or travel to, the blood vessels in the brain, heart, kidneys, lungs, and limbs. A clot in the veins deep in the limbs is called deep vein thrombosis (DVT). DVT usually affects the deep veins of the legs. If a blood clot in a deep vein breaks off and travels through the bloodstream to the lungs and blocks blood flow, it is called a pulmonary embolism. Other complications of blood clots include stroke, heart attack, kidney problems, kidney failure, and pregnancy-related problems. Treatments for blood clots include blood thinners and other medicines.", - "#" + NaN ], [ "Do I need to see a doctor for Low white blood cell count and cancer?: If you have any of the following symptoms, call your doctor: - Fevers, chills, or sweats. These may be signs of infection. - Diarrhea that does not go away or is bloody. - Severe nausea and vomiting. - Being unable to eat or drink. - Extreme weakness. - Redness, swelling, or drainage from any place where you have an IV line inserted into your body. - A new skin rash or blisters. - Pain in your stomach area. - A very bad headache or one that does not go away. - A cough that is getting worse. - Trouble breathing when you are at rest or when you are doing simple tasks. - Burning when you urinate.", @@ -365,7 +365,7 @@ ], [ "Pulmonary Embolism (Summary): Summary A pulmonary embolism is a sudden blockage in a lung artery. The cause is usually a blood clot in the leg called a deep vein thrombosis that breaks loose and travels through the bloodstream to the lung. Pulmonary embolism is a serious condition that can cause - Permanent damage to the affected lung - Low oxygen levels in your blood - Damage to other organs in your body from not getting enough oxygen If a clot is large, or if there are many clots, pulmonary embolism can cause death. Half the people who have pulmonary embolism have no symptoms. If you do have symptoms, they can include shortness of breath, chest pain or coughing up blood. Symptoms of a blood clot include warmth, swelling, pain, tenderness and redness of the leg. The goal of treatment is to break up clots and help keep other clots from forming. NIH: National Heart, Lung, and Blood Institute", - "#" + NaN ], [ "Vasculitis (Treatment): Treatment focuses on controlling the inflammation with medications and resolving any underlying disease that triggered your vasculitis. For your vasculitis, you may go through two treatment phases - first stopping the inflammation and then preventing relapse (maintenance therapy). Both phases involve prescription drugs. Which drugs and how long you need to take them depend on the type of vasculitis, the organs involved and how serious your condition is. Some people have initial success with treatment, then experience flare-ups later. Others may never see their vasculitis completely go away and need ongoing treatment. Medications Your doctor may prescribe a corticosteroid drug, such as prednisone or methylprednisolone (Medrol), to help control inflammation. Side effects of corticosteroids can be severe, especially if you take them for a long time. Possible side effects include weight gain, diabetes and bone thinning (osteoporosis). If a corticosteroid is needed for long-term (maintenance) therapy, you'll likely receive the lowest dose possible. Other medications may be prescribed with corticosteroids to control the inflammation so that the dosage of corticosteroids can be tapered more quickly. These medications are sometimes called steroid-sparing and may includemethotrexate (Trexall), azathioprine (Imuran, Azasan), mycophenolate (Cellcept) or cyclophosphamide. The specific medication that you'll need depends on the type and severity of vasculitis you have, which organs are involved, and any other medical problems that you have. Biologic therapies such as rituximab (Rituxan) or tocilizumab (Actemra) may be recommended, depending on the type of vasculitis you have. Surgery Sometimes, vasculitis causes a balloonlike bulge (aneurysm) to form in the wall of a blood vessel. This bulge may need surgery. Blocked arteries also may require surgical treatment.", @@ -613,7 +613,7 @@ ], [ "Ear Infections (Summary): Summary Ear infections are the most common reason parents bring their child to a doctor. Three out of four children will have at least one ear infection by their third birthday. Adults can also get ear infections, but they are less common. The infection usually affects the middle ear and is called otitis media. The tubes inside the ears become clogged with fluid and mucus. This can affect hearing, because sound cannot get through all that fluid. If your child isn't old enough to say \"My ear hurts,\" here are a few things to look for - Tugging at ears - Crying more than usual - Fluid draining from the ear - Trouble sleeping - Balance difficulties - Hearing problems Your health care provider will diagnose an ear infection by looking inside the ear with an instrument called an otoscope. Often, ear infections go away on their own. Your health care provider may recommend pain relievers. Severe infections and infections in young babies may require antibiotics. Children who get infections often may need surgery to place small tubes inside their ears. The tubes relieve pressure in the ears so that the child can hear again. NIH: National Institute on Deafness and Other Communication Disorders", - "#" + NaN ], [ "Otitis media with effusion (Exams and Tests): The health care provider may find OME while checking your child's ears after an ear infection has been treated. The provider will examine the eardrum and look for certain changes, such as: - Air bubbles on the surface of the eardrum - Dullness of the eardrum when a light is used - Eardrum that does not seem to move when little puffs of air are blown at it - Fluid behind the eardrum A test called tympanometry\u00a0is an accurate tool for diagnosing OME. The results of this test can help tell the amount and thickness of the fluid. The fluid in the middle ear can be accurately detected with: - Acoustic otoscope - Reflectometer: A portable device An audiometer or other type of formal hearing test may be done. This can help the provider decide on treatment.", @@ -757,7 +757,7 @@ ], [ "Diarrhea (Summary): Summary What is diarrhea? Diarrhea is loose, watery stools (bowel movements). You have diarrhea if you have loose stools three or more times in one day. Acute diarrhea is diarrhea that lasts a short time. It is a common problem. It usually lasts about one or two days, but it may last longer. Then it goes away on its own. Diarrhea lasting more than a few days may be a sign of a more serious problem. Chronic diarrhea -- diarrhea that lasts at least four weeks -- can be a symptom of a chronic disease. Chronic diarrhea symptoms may be continual, or they may come and go. Who gets diarrhea? People of all ages can get diarrhea. On average, adults In the United States have acute diarrhea once a year. Young children have it an average of twice a year. People who visit developing countries are at risk for traveler's diarrhea. It is caused by consuming contaminated food or water. What causes diarrhea? The most common causes of diarrhea include - Bacteria from contaminated food or water - Viruses such as the flu, norovirus, or rotavirus . Rotavirus is the most common cause of acute diarrhea in children. - Parasites, which are tiny organisms found in contaminated food or water - Medicines such as antibiotics, cancer drugs, and antacids that contain magnesium - Food intolerances and sensitivities, which are problems digesting certain ingredients or foods. An example is lactose intolerance. - Diseases that affect the stomach, small intestine, or colon, such as Crohn's disease - Problems with how the colon functions, such as irritable bowel syndrome Some people also get diarrhea after stomach surgery, because sometimes the surgeries can cause food to move through your digestive system more quickly. Sometimes no cause can be found. If your diarrhea goes away within a few days, finding the cause is usually not necessary. What other symptoms might I have with diarrhea? Other possible symptoms of diarrhea include - Cramps or pain in the abdomen - An urgent need to use the bathroom - Loss of bowel control If a virus or bacteria is the cause of your diarrhea, you may also have a fever, chills, and bloody stools. Diarrhea can cause dehydration, which means that your body does not have enough fluid to work properly. Dehydration can be serious, especially for children, older adults, and people with weakened immune systems. When should I see a doctor for diarrhea? Although it is usually not harmful, diarrhea can become dangerous or signal a more serious problem. Contact your health care provider if you have - Signs of dehydration - Diarrhea for more than 2 days, if you are an adult. For children, contact the provider if it lasts more than 24 hours. - Severe pain in your abdomen or rectum (for adults) - A fever of 102 degrees or higher - Stools containing blood or pus - Stools that are black and tarry If children have diarrhea, parents or caregivers should not hesitate to call a health care provider. Diarrhea can be especially dangerous in newborns and infants. How is the cause of diarrhea diagnosed? To find the cause of diarrhea, your health care provider may - Do a physical exam - Ask about any medicines you are taking - Test your stool or blood to look for bacteria, parasites, or other signs of disease or infection - Ask you to stop eating certain foods to see whether your diarrhea goes away If you have chronic diarrhea, your health care provider may perform other tests to look for signs of disease. What are the treatments for diarrhea? Diarrhea is treated by replacing lost fluids and electrolytes to prevent dehydration. Depending on the cause of the problem, you may need medicines to stop the diarrhea or treat an infection. Adults with diarrhea should drink water, fruit juices, sports drinks, sodas without caffeine, and salty broths. As your symptoms improve, you can eat soft, bland food. Children with diarrhea should be given oral rehydration solutions to replace lost fluids and electrolytes. Can diarrhea be prevented? Two types of diarrhea can be prevented - rotavirus diarrhea and traveler's diarrhea. There are vaccines for rotavirus. They are given to babies in two or three doses. You can help prevent traveler's diarrhea by being careful about what you eat and drink when you are in developing countries: - Use only bottled or purified water for drinking, making ice cubes, and brushing your teeth - If you do use tap water, boil it or use iodine tablets - Make sure that the cooked food you eat is fully cooked and served hot - Avoid unwashed or unpeeled raw fruits and vegetables NIH: National Institute of Diabetes and Digestive and Kidney Diseases", - "#" + NaN ], [ "Facts About Uveitis (What is Posterior\u00a0Uveitis?): Posterior uveitis is the least common form of uveitis. It primarily occurs in the back of the eye, often involving both the retina and the choroid. It is often called choroditis or chorioretinitis. There are many infectious and non-infectious causes to posterior\u00a0uveitis.", @@ -1925,11 +1925,11 @@ ], [ "Germs and Hygiene (Summary): Summary When you cough or sneeze, you send tiny germ-filled droplets into the air. Colds and flu usually spread that way. You can help stop the spread of germs by - Covering your mouth and nose when you sneeze or cough. Sneeze or cough into your elbow, not your hands. - Cleaning your hands often - always before you eat or prepare food, and after you use the bathroom or change a diaper - Avoiding touching your eyes, nose or mouth Hand washing is one of the most effective and most overlooked ways to stop disease. Soap and water work well to kill germs. Wash for at least 20 seconds and rub your hands briskly. Disposable hand wipes or gel sanitizers also work well.", - "#" + NaN ], [ "Common Cold (Summary): Summary Sneezing, sore throat, a stuffy nose, coughing - everyone knows the symptoms of the common cold. It is probably the most common illness. In the course of a year, people in the United States suffer 1 billion colds. You can get a cold by touching your eyes or nose after you touch surfaces with cold germs on them. You can also inhale the germs. Symptoms usually begin 2 or 3 days after infection and last 2 to 14 days. Washing your hands and staying away from people with colds will help you avoid colds. There is no cure for the common cold. For relief, try - Getting plenty of rest - Drinking fluids - Gargling with warm salt water - Using cough drops or throat sprays - Taking over-the-counter pain or cold medicines However, do not give aspirin to children. And do not give cough medicine to children under four. NIH: National Institute of Allergy and Infectious Diseases", - "#" + NaN ], [ "Cleaning to prevent the spread of germs (Summary): Germs from a person may be found on any object the person touched or on equipment that was used during the person's care. Some germs can live up to 5 months on a dry surface. Germs on any surface can pass to you or another person. Cleaning helps prevent the spread of germs. Your workplace has policies about how to clean: - Patient rooms - Spills or contamination - Supplies and equipment that are reusable", @@ -2173,11 +2173,11 @@ ], [ "Family Issues (Summary): Summary There are many kinds of families. Some have two parents, while others have a single parent. Sometimes there is no parent and grandparents raise grandchildren. Some children live in foster families, adoptive families, or in stepfamilies. Families are much more than groups of people who share the same genes or the same address. They should be a source of love and support. This does not mean that everyone gets along all the time. Conflicts are a part of family life. Many things can lead to conflict, such as illness, disability, addiction, job loss, school problems, and marital issues. Listening to each other and working to resolve conflicts are important in strengthening the family.", - "#" + NaN ], [ "Vitamin D Deficiency (Summary): Summary What is vitamin D deficiency? Vitamin D deficiency means that you are not getting enough vitamin D to stay healthy. Why do I need vitamin D and how do I get it? Vitamin D helps your body absorb calcium. Calcium is one of the main building blocks of bone. Vitamin D also has a role in your nervous, muscle, and immune systems. You can get vitamin D in three ways: through your skin, from your diet, and from supplements. Your body forms vitamin D naturally after exposure to sunlight. But too much sun exposure can lead to skin aging and skin cancer, so many people try to get their vitamin D from other sources. How much vitamin D do I need? The amount of vitamin D you need each day depends on your age. The recommended amounts, in international units (IU), are - Birth to 12 months: 400 IU - Children 1-13 years: 600 IU - Teens 14-18 years: 600 IU - Adults 19-70 years: 600 IU - Adults 71 years and older: 800 IU - Pregnant and breastfeeding women: 600 IU People at high risk of vitamin D deficiency may need more. Check with your health care provider about how much you need. What causes vitamin D deficiency? You can become deficient in vitamin D for different reasons: - You don't get enough vitamin D in your diet - You don't absorb enough vitamin D from food (a malabsorption problem) - You don't get enough exposure to sunlight. - Your liver or kidneys cannot convert vitamin D to its active form in the body. - You take medicines that interfere with your body's ability to convert or absorb vitamin D Who is at risk of vitamin D deficiency? Some people are at higher risk of vitamin D deficiency: - Breastfed infants, because human milk is a poor source of vitamin D. If you are breastfeeding, give your infant a supplement of 400 IU of vitamin D every day. - Older adults, because your skin doesn't make vitamin D when exposed to sunlight as efficiently as when you were young, and your kidneys are less able to convert vitamin D to its active form. - People with dark skin, which has less ability to produce vitamin D from the sun. - People with disorders such as Crohn's disease or celiac disease who don't handle fat properly, because vitamin D needs fat to be absorbed. - People who are obese, because their body fat binds to some vitamin D and prevents it from getting into the blood. - People who have had gastric bypass surgery - People with osteoporosis - People with chronic kidney or liver disease. - People with hyperparathyroidism (too much of a hormone that controls the body's calcium level) - People with sarcoidosis, tuberculosis, histoplasmosis, or other granulomatous disease (disease with granulomas, collections of cells caused by chronic inflammation) - People with some lymphomas, a type of cancer. - People who take medicines that affect vitamin D metabolism, such as cholestyramine (a cholesterol drug), anti-seizure drugs, glucocorticoids, antifungal drugs, and HIV/AIDS medicines. Talk with your health care provider if you are at risk for vitamin D deficiency. There is a blood test which can measure how much vitamin D is in your body. What problems does vitamin D deficiency cause? Vitamin D deficiency can lead to a loss of bone density, which can contribute to osteoporosis and fractures. Severe vitamin D deficiency can also lead to other diseases. In children, it can cause rickets. Rickets is a rare disease that causes the bones to become soft and bend. African American infants and children are at higher risk of getting rickets. In adults, severe vitamin D deficiency leads to osteomalacia. Osteomalacia causes weak bones, bone pain, and muscle weakness. Researchers are studying vitamin D for its possible connections to several medical conditions, including diabetes, high blood pressure, cancer, and autoimmune conditions such as multiple sclerosis. They need to do more research before they can understand the effects of vitamin D on these conditions. How can I get more vitamin D? There are a few foods that naturally have some vitamin D: - Fatty fish such as salmon, tuna, and mackerel - Beef liver - Cheese - Mushrooms - Egg yolks You can also get vitamin D from fortified foods. You can check the food labels to find out whether a food has vitamin D. Foods that often have added vitamin D include - Milk - Breakfast cereals - Orange juice - Other dairy products, such as yogurt - Soy drinks Vitamin D is in many multivitamins. There are also vitamin D supplements, both in pills and a liquid for babies. If you have vitamin D deficiency, the treatment is with supplements. Check with your health care provider about how much you need to take, how often you need to take it, and how long you need to take it. Can too much vitamin D be harmful? Getting too much vitamin D (known as vitamin D toxicity) can be harmful. Signs of toxicity include nausea, vomiting, poor appetite, constipation, weakness, and weight loss. Excess vitamin D can also damage the kidneys. Too much vitamin D also raises the level of calcium in your blood. High levels of blood calcium (hypercalcemia) can cause confusion, disorientation, and problems with heart rhythm. Most cases of vitamin D toxicity happen when someone overuses vitamin D supplements. Excessive sun exposure doesn't cause vitamin D poisoning because the body limits the amount of this vitamin it produces.", - "#" + NaN ], [ "How effective is Vitamin K?: Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate. The effectiveness ratings for VITAMIN K are as follows: Effective for... - Preventing bleeding problems in newborns with low levels of vitamin K (hemorrhagic disease). Giving vitamin K1 by mouth or as an injection into the muscles can prevent bleeding problems in newborns. - Treating and preventing bleeding problems in people with low levels of the blood clotting protein prothrombin. Taking vitamin K1 by mouth or as an injection into the vein can prevent and treat bleeding problems in people with low levels of prothrombin due to using certain medications. - An inherited bleeding disorder called vitamin K-dependent clotting factors deficiency (VKCFD). Taking vitamin K by mouth or injecting it intravenously (by IV) helps prevent bleeding in individuals with VKCFD. - Reversing the effects of too much warfarin used to prevent blood clotting. Taking vitamin K1 by mouth or as in injection into the vein can counteract too much anticoagulation caused by warfarin. However, injecting vitamin K1 under the skin does not seem to be effective. Taking vitamin K along with warfarin also seems to help stabilize blood clotting time in people taking warfarin, especially those who have low vitamin K levels. Possibly ineffective for... - Bleeding within the fluid-filled areas (ventricles) of the brain (intraventricular hemorrhage). Giving vitamin K to women at risk for very preterm births might reduce the severity of intraventricular hemorrhage in preterm infants. However, it does not seem to prevent intraventricular hemorrhage nor the brain injuries associated with intraventricular hemorrhage. Insufficient evidence to rate effectiveness for... - Breast cancer. Population research suggests that higher dietary intake of vitamin K2 is linked with a lower risk of developing breast cancer. - Cancer. Population research suggests that higher dietary intake of vitamin K2 is linked with a lower risk of cancer-related death. However, it does not seem to be linked with a lower risk of developing cancer. Higher dietary intake of vitamin K1 does not seem to be linked with a lower risk of cancer or cancer-related death. - Heart disease. Research suggests that higher dietary intake of vitamin K2 is associated with a lower risk of coronary calcification, which occurs when the inner lining of the coronary arteries develops a layer of plaque, as well as a lower risk of death caused by coronary heart disease. Dietary vitamin K2 can be obtained from cheese, other milk products, and meat. Dietary intake of vitamin K1 does not seem to have an effect on heart disease risk. However supplementation with vitamin K1 seems to prevent or reduce the advancement of coronary calcification. - Cystic fibrosis. People with cystic fibrosis can have low levels of vitamin K due to problems digesting fat. Taking a combination of vitamins A, D, E, and K seems to improve vitamin K levels in people with cystic fibrosis who have trouble digesting fat. Also, early research suggests that taking vitamin K by mouth for can enhance the production of osteocalcin, which plays a role in the bodys bone-building and metabolic regulation. However, there is no reliable evidence suggesting it improves overall health in people with cystic fibrosis. - Diabetes. Early research suggests that taking a multivitamin fortified with vitamin K1 does not lower the risk of developing diabetes compared to taking a regular multivitamin. - High cholesterol. There is early evidence that vitamin K2 might lower cholesterol in people on dialysis with high cholesterol levels. - Liver cancer. Taking vitamin K2 does not seem to prevent liver cancer from recurring after curative or possibly curative treatment. However, some early research suggests that vitamin K2 might prevent the development of liver cancer in people with liver cirrhosis. - Lung cancer. Early research suggests that higher dietary intake of vitamin K2 is linked with a reduced risk of lung cancer and lung cancer-related death. Dietary intake of vitamin K1 does not seem to be linked with a reduced risk of these events. - Weak bones (osteoporosis). So far, research results on the effects of vitamin K on bone strength and fracture risk in people with osteoporosis dont agree. - Prostate cancer. Early research suggests that higher dietary intake of vitamin K2, but not vitamin K1, is linked with a reduced risk of prostate cancer. - Stroke. Population research suggests that dietary intake of vitamin K1 is not linked with a reduced risk of stroke. - Spider veins. - Bruises. - Scars. - Stretch marks. - Burns. - Swelling. - Other conditions. More evidence is needed to rate vitamin K for these uses.", @@ -2413,7 +2413,7 @@ ], [ "Laboratory Tests (Summary): Summary Laboratory tests check a sample of your blood, urine, or body tissues. A technician or your doctor analyzes the test samples to see if your results fall within the normal range. The tests use a range because what is normal differs from person to person. Many factors affect test results. These include - Your sex, age and race - What you eat and drink - Medicines you take - How well you followed pre-test instructions Your doctor may also compare your results to results from previous tests. Laboratory tests are often part of a routine checkup to look for changes in your health. They also help doctors diagnose medical conditions, plan or evaluate treatments, and monitor diseases.", - "#" + NaN ], [ "What are the genetic changes related to osteogenesis imperfecta?: Mutations in the COL1A1, COL1A2, CRTAP, and P3H1 genes cause osteogenesis imperfecta. Mutations in the COL1A1 and COL1A2 genes are responsible for more than 90 percent of all cases of osteogenesis imperfecta. These genes provide instructions for making proteins that are used to assemble type I collagen. This type of collagen is the most abundant protein in bone, skin, and other connective tissues that provide structure and strength to the body. Most of the mutations that cause osteogenesis imperfecta type I occur in the COL1A1 gene. These genetic changes reduce the amount of type I collagen produced in the body, which causes bones to be brittle and to fracture easily. The mutations responsible for most cases of osteogenesis imperfecta types II, III, and IV occur in either the COL1A1 or COL1A2 gene. These mutations typically alter the structure of type I collagen molecules. A defect in the structure of type I collagen weakens connective tissues, particularly bone, resulting in the characteristic features of osteogenesis imperfecta. Mutations in the CRTAP and P3H1 genes are responsible for rare, often severe cases of osteogenesis imperfecta. Cases caused by CRTAP mutations are usually classified as type VII; when P3H1 mutations underlie the condition, it is classified as type VIII. The proteins produced from these genes work together to process collagen into its mature form. Mutations in either gene disrupt the normal folding, assembly, and secretion of collagen molecules. These defects weaken connective tissues, leading to severe bone abnormalities and problems with growth. In cases of osteogenesis imperfecta without identified mutations in one of the genes described above, the cause of the disorder is unknown. These cases include osteogenesis imperfecta types V and VI. Researchers are working to identify additional genes that may be responsible for these conditions.", @@ -2505,7 +2505,7 @@ ], [ "How to Prevent High Blood Pressure (Summary): Summary About 1 in 3 adults in the U.S. has high blood pressure, or hypertension, but many don't realize it. High blood pressure usually has no warning signs, yet it can lead to life-threatening conditions like heart attack or stroke. The good news is that you can often prevent or treat high blood pressure. Early diagnosis and simple, healthy changes can keep high blood pressure from seriously damaging your health. What is blood pressure? Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is called diastolic pressure. Your blood pressure reading uses these two numbers. Usually the systolic number comes before or above the diastolic number. How do I know if my blood pressure is high? High blood pressure usually has no symptoms. So the only way to find out if you have high blood pressure is to get regular blood pressure checks from your health care provider. Your provider will use a gauge, a stethoscope or electronic sensor, and a blood pressure cuff. For most adults, blood pressure readings will be in one of four categories: Normal blood pressure means - Your systolic pressure is less than 120 AND - Your diastolic pressure is less than 80 Prehypertension means - Your systolic pressure is between 120-139 OR - Your diastolic pressure is between 80-89 Stage 1 high blood pressure means - Your systolic pressure is between 140-159 OR - Your diastolic pressure is between 90-99 Stage 2 high blood pressure means - Your systolic pressure is 160 or higher OR - Your diastolic pressure is 100 or higher For children and teens, the health care provider compares the blood pressure reading to what is normal for other kids who are the same age, height, and gender. People with diabetes or chronic kidney disease should keep their blood pressure below 130/80. Why do I need to worry about prehypertension and high blood pressure? Prehypertension means you're likely to end up with high blood pressure, unless you take steps to prevent it. When your blood pressure stays high over time, it causes the heart to pump harder and work overtime, possibly leading to serious health problems such as heart attack, stroke, heart failure, and kidney failure. What are the different types of high blood pressure? There are two main types of high blood pressure: primary and secondary high blood pressure. - Primary, or essential, high blood pressure is the most common type of high blood pressure. For most people who get this kind of blood pressure, it develops over time as you get older. - Secondary high blood pressure is caused by another medical condition or use of certain medicines. It usually gets better after you treat the cause or stop taking the medicines that are causing it. Who is at risk for high blood pressure? Anyone can develop high blood pressure, but there are certain factors that can increase your risk: - Age - Blood pressure tends to rise with age - Race/Ethnicity - High blood pressure is more common in African American adults - Weight - People who are overweight or obese are more likely to develop prehypertension or high blood pressure - Gender - Before age 55, men are more likely than women to develop high blood pressure. After age 55, women are more likely than men to develop it. - Lifestyle - Certain lifestyle habits can raise your risk for high blood pressure, such as eating too much sodium or not enough potassium, lack of exercise, drinking too much alcohol, and smoking. - Family history - A family history of high blood pressure raises the risk of developing prehypertension or high blood pressure How can I prevent high blood pressure? You can help prevent high blood pressure by having a healthy lifestyle. This means - Eating a healthy diet. To help manage your blood pressure, you should limit the amount of sodium (salt) that you eat, and increase the amount of potassium in your diet. It is also important to eat foods that are lower in fat, as well as plenty of fruits, vegetables, and whole grains. The DASH diet is an example of an eating plan that can help you to lower your blood pressure. - Getting regular exercise. Exercise can help you maintain a healthy weight and lower your blood pressure. You should try to get moderate-intensity aerobic exercise at least 2 and a half hours per week, or vigorous-intensity aerobic exercise for 1 hour and 15 minutes per week. Aerobic exercise, such as brisk walking, is any exercise in which your heart beats harder and you use more oxygen than usual. - Being at a healthy weight. Being overweight or obese increases your risk for high blood pressure. Maintaining a healthy weight can help you control high blood pressure and reduce your risk for other health problems. - Limiting alcohol. Drinking too much alcohol can raise your blood pressure. It also adds extra calories, which may cause weight gain. Men should have no more than two drinks per day, and women only one. - Not smoking. Cigarette smoking raises your blood pressure and puts you at higher risk for heart attack and stroke. If you do not smoke, do not start. If you do smoke, talk to your health care provider for help in finding the best way for you to quit. - Managing stress. Learning how to relax and manage stress can improve your emotional and physical health and lower high blood pressure. Stress management techniques include exercising, listening to music, focusing on something calm or peaceful, and meditating. If you already have high blood pressure, it is important to prevent it from getting worse or causing complications. You should get regular medical care and follow your prescribed treatment plan. Your plan will include healthy lifestyle habit recommendations and possibly medicines. NIH: National Heart, Lung, and Blood Institute", - "#" + NaN ], [ "High blood pressure (Some High Blood Pressure Risks You Can\u2019t Change): Anyone can get high blood pressure. But, some people have a greater chance of having it because of things they can't change. These are:- Age. The chance of having high blood pressure increases as you get older. - Gender. Before age 55, men have a greater chance of having high blood pressure. Women are more likely to have high blood pressure after menopause. - Family history. High blood pressure tends to run in some families. - Race. African Americans are at increased risk for high blood pressure.", @@ -2617,7 +2617,7 @@ ], [ "Intestinal Cancer (Summary): Summary Your small intestine is part of your digestive system. It is a long tube that connects your stomach to your large intestine. Intestinal cancer is rare, but eating a high-fat diet or having Crohn's disease, celiac disease, or a history of colonic polyps can increase your risk. Possible signs of small intestine cancer include - Abdominal pain - Weight loss for no reason - Blood in the stool - A lump in the abdomen Imaging tests that create pictures of the small intestine and the area around it can help diagnose intestinal cancer and show whether it has spread. Surgery is the most common treatment. Additional options include chemotherapy, radiation therapy, or a combination. NIH: National Cancer Institute", - "#" + NaN ], [ "Vulva cancer (Outlook (Prognosis)): Most women with vulvar cancer who are diagnosed and treated at an early stage do well. But a woman's outcome depends on: - The size of the tumor - The type of vulvar cancer - Whether the cancer has spread The cancer commonly comes back at or near the site of the original tumor.", @@ -2793,7 +2793,7 @@ ], [ "Erectile Dysfunction (Summary): Summary Erectile dysfunction (ED) is a common type of male sexual dysfunction. It is when a man has trouble getting or keeping an erection. ED becomes more common as you get older. But it's not a natural part of aging. Some people have trouble speaking with their doctors about sex. But if you have ED, you should tell your doctor. ED can be a sign of health problems. It may mean your blood vessels are clogged. It may mean you have nerve damage from diabetes. If you don't see your doctor, these problems will go untreated. Your doctor can offer several new treatments for ED. For many men, the answer is as simple as taking a pill. Getting more exercise, losing weight, or stopping smoking may also help. NIH: National Institute of Diabetes and Digestive and Kidney Diseases", - "#" + NaN ], [ "Erectile Dysfunction (ED) (Treatment): You can work with a health care professional to treat an underlying cause of your erectile dysfunction (ED). Choosing an ED treatment is a personal decision. However, you also may benefit from talking with your partner about which treatment is best for you as a couple.Your health care professional may suggest that you make lifestyle changes to help reduce or improve ED. You canquit smoking limit or stop drinking alcohol increase physical activity and maintain a healthy body weight stop illegal drug useYou can seek help from a health professional if you have trouble making these changes on your own.Talk with your doctor about going to a counselor if psychological or emotional issues are affecting your ED. A counselor can teach you how to lower your anxiety or stress related to sex. Your counselor may suggest that you bring your partner to counseling sessions to learn how to support you. As you work on relieving your anxiety or stress, a doctor can focus on treating the physical causes of ED.", @@ -2809,7 +2809,7 @@ ], [ "Prescription Drug Abuse (Summary): Summary If you take a medicine in a way that is different from what the doctor prescribed, it is called prescription drug abuse. It could be - Taking a medicine that was prescribed for someone else - Taking a larger dose than you are supposed to - Taking the medicine in a different way than you are supposed to. This might be crushing tablets and then snorting or injecting them. - Using the medicine for another purpose, such as getting high Abusing some prescription drugs can lead to addiction. These include opioids, sedatives, tranquilizers, and stimulants. Every medicine has some risk of side effects. Doctors take this into account when prescribing medicines. People who abuse these drugs may not understand the risks. The medicines may not be safe for them, especially at higher doses or when taken with other medicines. NIH: National Institute on Drug Abuse", - "#" + NaN ], [ "Prescription drug abuse (Diagnosis): Doctors generally base a diagnosis of prescription drug abuse on medical history and answers to other questions. In some cases, certain signs and symptoms also provide clues. Blood or urine tests can detect many types of drugs. These tests can also help track the progress of a person who's getting treatment.", @@ -2821,7 +2821,7 @@ ], [ "Medicare Prescription Drug Coverage (Summary): Summary Part D is the name of Medicare's prescription drug coverage. It's insurance that helps people pay for prescription drugs. It is available to everyone who has Medicare. It provides protection if you pay high drug costs or have unexpected prescription drug bills. It doesn't cover all costs. You have to pay part of the cost of prescription drugs. Most people also have to pay an additional monthly cost. Private companies provide Medicare prescription drug coverage. You choose the drug plan you like best. Whether or not you should sign up depends on how good your current coverage is. You need to sign up as soon as you are eligible for Medicare. Otherwise, there may be additional charges. Centers for Medicare and Medicaid Services", - "#" + NaN ], [ "General anesthesia: General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive these medicines, you will not be aware of what is happening around you. Most times, a doctor called an anesthesiologist will give you the anesthesia. Sometimes, a certified and registered nurse anesthetist will take care of you. The medicine is given into your vein. You may be asked to breathe in (inhale) a special gas through a mask. Once you are asleep, the doctor may insert a tube into your windpipe (trachea) to help you breathe and protect your lungs. You will be watched very closely while you are asleep. Your blood pressure, pulse, and breathing will be monitored. The health care provider taking care of you can change how deeply asleep you are during the surgery. You will not move, feel any pain, or have any memory of the procedure because of this medicine. General anesthesia is a safe way to stay asleep and pain-free during procedures that would: - Be too painful - Take a long time - Affect your ability to breathe - Make you uncomfortable - Cause too much anxiety You may also be able to have conscious sedation for your procedure. Sometimes, though, it is not enough to make you comfortable. Children may need general anesthesia for a medical or dental procedure to handle any pain or anxiety they may feel. General anesthesia is usually safe for healthy people. You may have a higher risk of problems with general anesthesia if you: - Abuse alcohol or medicines - Have allergies or a family history of being allergic to medicines - Have heart, lung, or kidney problems - Smoke Ask your doctor about these complications: - Death (rare) - Harm to your vocal cords - Heart attack - Lung infection - Mental confusion (temporary) - Stroke - Trauma to the teeth or tongue - Waking during anesthesia (rare) - Allergy to the drugs - Malignant hyperthermia (fast rise in body temperature and severe muscle contractions) Tell your provider: - If you could be pregnant - What medicines you are taking, even drugs or herbs you bought without a prescription During the days before the surgery: - An anesthesiologist will take a complete medical history to determine the type and amount of the anesthesia you need. This includes asking you about any allergies, health conditions, medicines, and history of anesthesia. - Several days to a week before surgery, you may be asked to stop taking blood thinning drugs, such as aspirin, ibuprofen (Advil, Motrin), and warfarin (Coumadin, Jantoven). - Ask your provider which drugs you should still take on the day of your surgery. - Always try to stop smoking. Your doctor can help. On the day of your surgery: - You will likely be asked not to drink or eat anything after midnight the night before the surgery. This is to prevent you from vomiting while you are under the effect of the anesthesia. Vomiting can cause food in the stomach to be inhaled into the lungs. This can lead to breathing problems. - Take the drugs that your provider told you to take with a small sip of water. - Arrive at the hospital on time. You will wake up tired and groggy in the recovery or operating room. You may also feel sick to your stomach, and have a dry mouth, sore throat, or feel cold or restless until the effect of the anesthesia wears off. Your nurse will monitor these side effects, which will wear off, but it may take a few hours. Sometimes, nausea and vomiting can be treated with other medicines. Follow your surgeon's instructions while you recover and care for your surgical wound. General anesthesia is generally safe because of modern equipment, medicines, and safety standards. Most people recover completely and do not have any complications. Updated by: Mary C. Mancini, MD, PhD, Department of Surgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.", @@ -2937,7 +2937,7 @@ ], [ "Flu Shot (Summary): Summary Flu is a respiratory infection caused by a number of viruses. Most people with the flu get better on their own. But it can be serious. It can cause complications and sometimes even death. Getting the flu vaccine every year is the best way to lower your chance of getting the flu and spreading it to others. The flu vaccine causes antibodies to develop in your body about two weeks after you get it. These antibodies provide protection against infection with the viruses that are in the vaccine. There are different types of flu shots, including some especially for people 65 and older. Ask your health care provider which one is right for you. Everyone 6 months of age and older should get a flu vaccine every season. People with egg allergies should check with their doctors before getting a vaccine. Other exceptions are people who have - Had reactions to flu shots before - Guillain-Barre Syndrome - A fever Centers for Disease Control and Prevention", - "#" + NaN ], [ "Swine flu (H1N1 flu): Technically, the term \"swine flu\" refers to influenza in pigs. Occasionally, pigs transmit influenza viruses to people, mainly to hog farmers and veterinarians. Less often, someone infected with swine flu passes the infection to others. The human respiratory infection caused by a particular influenza virus H1N1 strain - popularly known as swine flu - was first recognized in spring 2009. A few months after the first swine flu cases were reported, rates of confirmed H1N1-related illness were increasing in much of the world. As a result, the World Health Organization declared the infection a global pandemic. The pandemic was declared over in August 2010. Currently, H1N1 is still circulating in humans as a seasonal flu virus and protection against this strain was included in the seasonal flu vaccine for 2015-16. Another strain, H3N2 emerged in humans in 2011. H1N1 flu signs and symptoms in humans are similar to those of other flu strains: - Fever (but not always) - Cough - Sore throat - Runny or stuffy nose - Watery, red eyes - Body aches - Headache - Fatigue - Diarrhea - Nausea and vomiting H1N1 flu symptoms develop about one to three days after you're exposed to the virus. When to see a doctor It's not necessary to see a doctor if you're generally healthy and develop flu signs and symptoms, such as fever, cough and body aches. Call your doctor, however, if you have flu symptoms and you're pregnant or you have a chronic disease, such as asthma, emphysema, diabetes or a heart condition, because you have a higher risk of complications from the flu. Influenza viruses infect the cells lining your nose, throat and lungs. The virus enters your body when you inhale contaminated droplets or transfer live virus from a contaminated surface to your eyes, nose or mouth. You can't catch swine flu from eating pork. If you've traveled to an area where many people are affected by swine flu (H1N1 flu), you may have been exposed to the virus, particularly if you spent time in large crowds. Swine farmers and veterinarians have the highest risk of true swine flu because of their exposure to pigs. Influenza complications include: - Worsening of chronic conditions, such as heart disease and asthma - Pneumonia - Neurological signs and symptoms, ranging from confusion to seizures - Respiratory failure Most cases of flu, including H1N1 flu, require only symptom relief. If you have a chronic respiratory disease, your doctor may prescribe additional medications to help relieve your symptoms. The antiviral drugs oseltamivir (Tamiflu) and zanamivir (Relenza) are sometimes prescribed within the first day or two of symptoms to reduce the severity of your symptoms, and possibly the risk of complications. But, flu viruses can develop resistance to these drugs. To make development of resistance less likely and maintain supplies of these drugs for those who need them most, antivirals are reserved for people at high risk of complications. High-risk groups are those who: - Are in a hospital, nursing home or other long-term care facility - Are younger than 5 years of age, particularly children younger than 2 years - Are 65 years and older - Are pregnant or within two weeks of delivery, including women who have had pregnancy loss - Are younger than 19 years of age and are receiving long-term aspirin therapy, because of an increased risk of developing Reye's syndrome, a rare but potentially fatal disease that can occur when using aspirin during a viral illness - Are morbidly obese, defined as having a body mass index above 40 - Have certain chronic medical conditions, including asthma, emphysema, heart disease, diabetes, neuromuscular disease, or kidney, liver or blood disease - Are immunosuppressed due to certain medications or HIV - Are American Indians or Native Alaskans", @@ -2993,7 +2993,7 @@ ], [ "H1N1 Flu (Swine Flu) (Summary): Summary Swine flu is an infection caused by a virus. It's named for a virus that pigs can get. People do not normally get swine flu, but human infections can and do happen. In 2009 a strain of swine flu called H1N1 infected many people around the world. The virus is contagious and can spread from human to human. Symptoms of swine flu in people are similar to the symptoms of regular human flu and include fever, cough, sore throat, body aches, headache, chills and fatigue. There are antiviral medicines you can take to prevent or treat swine flu. There is a vaccine available to protect against swine flu. You can help prevent the spread of germs that cause respiratory illnesses like influenza by - Covering your nose and mouth with a tissue when you cough or sneeze. Throw the tissue in the trash after you use it. - Washing your hands often with soap and water, especially after you cough or sneeze. You can also use alcohol-based hand cleaners. - Avoiding touching your eyes, nose or mouth. Germs spread this way. - Trying to avoid close contact with sick people. - Staying home from work or school if you are sick. Centers for Disease Control and Prevention", - "#" + NaN ], [ "Flu: The flu is an infection of the nose, throat, and lungs. It spreads easily. This article discusses influenza types A and B. Another type of the flu is the swine flu (H1N1). The flu is caused by an influenza virus. Most people get the flu when they breathe in tiny airborne droplets from the coughs or sneezes of someone who has the flu. You can also catch the flu if you touch something with the virus on it, and then touch your mouth, nose, or eyes. People often confuse colds and flu. They are different, but you might have some of the same symptoms. Most people get a cold several times a year. On the contrary, people get the flu only once every few years. Sometimes, you can get a virus that makes you throw up or have diarrhea. Some people call this the \"stomach flu.\" This is a misleading name because this virus is not the actual flu. The flu mostly affects your nose, throat, and lungs. Flu symptoms will often start quickly. You can start to feel sick about 1 to 7 days after you come in contact with the virus. Most of the time symptoms appear within 2 to 3 days. The flu spreads easily. It can affect a large group of people in a very short amount of time. For example, students and co-workers get sick within 2 or 3 weeks of the flu's arrival in a school or workplace. The first symptom is a fever between 102\u00b0F (39\u00b0C) and 106\u00b0F (41\u00b0C). An adult often has a lower fever than a child. Other common symptoms include: - Body aches - Chills - Dizziness - Flushed face - Headache - Lack of energy - Nausea and vomiting The fever, aches, and pains begin to go away on days 2 through 4. But new symptoms occur, including: - Dry cough - Increased symptoms that affect breathing - Runny nose (clear and watery) - Sneezing - Sore throat Most symptoms go away in 4 to 7 days. The cough and tired feeling may last for weeks. Sometimes, the fever comes back. Some people may not feel like eating. The flu can make asthma, breathing problems, and other long-term (chronic) illnesses and conditions worse. Most people do not need to see a health care provider when they have flu symptoms. This is because most people are not at risk for a severe case of the flu. If you are very sick with the flu, you may want to see your provider. People who are at high risk for flu complications may also want to see a provider if they get the flu. When many people in an area have flu, a provider can make a diagnosis after hearing about your symptoms. No further testing is needed. There is a test to detect the flu. It is done by swabbing the nose or throat. Most of the time, test results are available very fast. The test can help your provider prescribe the best treatment. HOME CARE Acetaminophen (Tylenol) and ibuprofen (Advil, Motrin) help lower fever. Providers sometimes suggest you to use both types of medicine. DO NOT use aspirin. A fever does not need to come all the way down to normal. Most people feel better when the temperature drops by 1 degree. Over-the-counter cold medicines may make some of your symptoms better. Cough drops or throat sprays will help with your sore throat. You will need a lot of rest. Drink plenty of liquids. DO NOT smoke or drink alcohol. ANTIVIRAL DRUGS Most people with milder symptoms feel better in 3 to 4 days. They do not need to see a provider or take antiviral medicines. Providers may give antiviral drugs to people who get very sick with the flu. You may need these medicines if you are more likely to have flu complications The health problems below may increase your risk of getting sicker with the flu: - Lung disease (including asthma) - Heart conditions (except high blood pressure) - Kidney, liver, nerve, and muscle conditions - Blood disorders (including sickle cell disease) - Diabetes - A weakened immune system due to diseases (such as AIDS), radiation therapy, or certain medicines, including chemotherapy and corticosteroids - Other long-term medical problem These medicines may shorten the time you have symptoms by about 1 day. They work better if you start taking them within 2 days of your first symptoms. Children at risk of a severe case of the flu may also need these medicines. Millions of people in the United States get the flu each year. Most people get better within a week or two, but thousands of people with the flu develop pneumonia or a brain infection. They need to stay in the hospital. About 36,000 people in the United States die each year of problems from the flu. Anyone at any age can have serious complications from the flu. Those at highest risk include: - People over the age of 65 - Children younger than 2 years old - Women who are more than 3 months pregnant - Anyone living in a long-term care facility - Anyone with chronic heart, lung, or kidney conditions, diabetes, or a weakened immune system Complications may include: - Pneumonia - Encephalitis (infection of the brain) - Meningitis - Seizures Call your provider if you get the flu and think you are at risk for having complications. Also, call your provider if your flu symptoms are very bad and self-treatment is not working. You can take steps to avoid catching or spreading the flu. The best step is to get a flu vaccine. If you have the flu: - Stay in your apartment, dorm room, or home for at least 24 hours after your fever has gone. - Wear a mask if you leave your room. - Avoid sharing food, utensils, cups, or bottles. - Use hand sanitizer often during the day and always after touching your face. - Cover your mouth with a tissue when coughing and throw it away after use. - Cough into your sleeve if a tissue is not available. Avoid touching your eyes, nose, and mouth. The Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months and older should receive the influenza vaccine. For the 2016-2017 season, CDC recommends use of the flu shot (inactivated influenza vaccine or IIV) and the recombinant influenza vaccine (RIV). The nasal spray flu vaccine (live attenuated influenza vaccine or LAIV) should not be used during 2016-2017. Updated by: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Internal review and update on 09/01/2016 by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.", @@ -3193,7 +3193,7 @@ ], [ "Ischemic Stroke (Summary): Summary A stroke is a medical emergency. There are two types - ischemic and hemorrhagic. Ischemic stroke is the most common type. It is usually caused by a blood clot that blocks or plugs a blood vessel in the brain. This keeps blood from flowing to the brain. Within minutes, brain cells begin to die. Another cause is stenosis, or narrowing of the artery. This can happen because of atherosclerosis, a disease in which plaque builds up inside your arteries. Transient ischemic attacks (TIAs) occur when the blood supply to the brain is interrupted briefly. Having a TIA can mean you are at risk for having a more serious stroke. Symptoms of stroke are - Sudden numbness or weakness of the face, arm or leg (especially on one side of the body) - Sudden confusion, trouble speaking or understanding speech - Sudden trouble seeing in one or both eyes - Sudden trouble walking, dizziness, loss of balance or coordination - Sudden severe headache with no known cause It is important to treat strokes as quickly as possible. Blood thinners may be used to stop a stroke while it is happening by quickly dissolving the blood clot. Post-stroke rehabilitation can help people overcome disabilities caused by stroke damage. NIH: National Institute of Neurological Disorders and Stroke", - "#" + NaN ], [ "Stroke: A stroke occurs if the flow of oxygen-rich blood to a portion of the brain is blocked. Without oxygen, brain cells start to die after a few minutes. Sudden bleeding in the brain also can cause a stroke if it damages brain cells. If brain cells die or are damaged because of a stroke, symptoms occur in the parts of the body that these brain cells control. Examples of stroke symptoms include sudden weakness; paralysis or numbness of the face, arms, or legs (paralysis is an inability to move); trouble speaking or understanding speech; and trouble seeing. A stroke is a serious medical condition that requires emergency care. A stroke can cause lasting brain damage, long-term disability, or even death. If you think you or someone else is having a stroke, call 9\u20131\u20131 right away. Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room. During a stroke, every minute counts. Overview The two main types of stroke are ischemic (is-KE-mik) and hemorrhagic (hem-ah-RAJ-ik). Ischemic is the more common type of stroke. An ischemic stroke occurs if an artery that supplies oxygen-rich blood to the brain becomes blocked. Blood clots often cause the blockages that lead to ischemic strokes. A hemorrhagic stroke occurs if an artery in the brain leaks blood or ruptures (breaks open). The pressure from the leaked blood damages brain cells. High blood pressure and aneurysms (AN-u-risms) are examples of conditions that can cause hemorrhagic strokes. (Aneurysms are balloon-like bulges in an artery that can stretch and burst.) Another condition that\u2019s similar to a stroke is a transient ischemic attack, also called a TIA or \u201cmini-stroke.\u201d A TIA occurs if blood flow to a portion of the brain is blocked only for a short time. Thus, damage to the brain cells isn\u2019t permanent (lasting). Like ischemic strokes, TIAs often are caused by blood clots. Although TIAs are not full-blown strokes, they greatly increase the risk of having a stroke. If you have a TIA, it\u2019s important for your doctor to find the cause so you can take steps to prevent a stroke. Both strokes and TIAs require emergency care. Outlook Stroke is a leading cause of death in the United States. Many factors can raise your risk of having a stroke. Talk with your doctor about how you can control these risk factors and help prevent a stroke. If you have a stroke, prompt treatment can reduce damage to your brain and help you avoid lasting disabilities. Prompt treatment also may help prevent another stroke. Researchers continue to study the causes and risk factors for stroke. They\u2019re also finding new and better treatments and new ways to help the brain repair itself after a stroke. Ischemic Stroke An ischemic stroke occurs if an artery that supplies oxygen-rich blood to the brain becomes blocked. Blood clots often cause the blockages that lead to ischemic strokes. The two types of ischemic stroke are thrombotic (throm-BOT-ik) and embolic (em-BOL-ik). In a thrombotic stroke, a blood clot (thrombus) forms in an artery that supplies blood to the brain. In an embolic stroke, a blood clot or other substance (such as plaque, a fatty material) travels through the bloodstream to an artery in the brain. (A blood clot or piece of plaque that travels through the bloodstream is called an embolus.) With both types of ischemic stroke, the blood clot or plaque blocks the flow of oxygen-rich blood to a portion of the brain. Ischemic Stroke Hemorrhagic Stroke A hemorrhagic stroke occurs if an artery in the brain leaks blood or ruptures (breaks open). The pressure from the leaked blood damages brain cells. The two types of hemorrhagic stroke are intracerebral (in-trah-SER-e-bral) and subarachnoid (sub-ah-RAK-noyd). In an intracerebral hemorrhage, a blood vessel inside the brain leaks blood or ruptures. In a subarachnoid hemorrhage, a blood vessel on the surface of the brain leaks blood or ruptures. When this happens, bleeding occurs between the inner and middle layers of the membranes that cover the brain. In both types of hemorrhagic stroke, the leaked blood causes swelling of the brain and increased pressure in the skull. The swelling and pressure damage cells and tissues in the brain. Hemorrhagic Stroke Brain attack Cerebrovascular accident (CVA) Hemorrhagic stroke (includes intracerebral hemorrhage and subarachnoid hemorrhage) Ischemic stroke (includes thrombotic stroke and embolic stroke) A transient ischemic attack sometimes is called a TIA or mini-stroke. A TIA has the same symptoms as a stroke, and it increases your risk of having a stroke. Ischemic Stroke and Transient Ischemic Attack An ischemic stroke or transient ischemic attack (TIA) occurs if an artery that supplies oxygen-rich blood to the brain becomes blocked. Many medical conditions can increase the risk of ischemic stroke or TIA. For example, atherosclerosis (ath-er-o-skler-O-sis) is a disease in which a fatty substance called plaque builds up on the inner walls of the arteries. Plaque hardens and narrows the arteries, which limits the flow of blood to tissues and organs (such as the heart and brain). Plaque in an artery can crack or rupture (break open). Blood platelets (PLATE-lets), which are disc-shaped cell fragments, stick to the site of the plaque injury and clump together to form blood clots. These clots can partly or fully block an artery. Plaque can build up in any artery in the body, including arteries in the heart, brain, and neck. The two main arteries on each side of the neck are called the carotid (ka-ROT-id) arteries. These arteries supply oxygen-rich blood to the brain, face, scalp, and neck. When plaque builds up in the carotid arteries, the condition is called carotid artery disease. Carotid artery disease causes many of the ischemic strokes and TIAs that occur in the United States. An embolic stroke (a type of ischemic stroke) or TIA also can occur if a blood clot or piece of plaque breaks away from the wall of an artery. The clot or plaque can travel through the bloodstream and get stuck in one of the brain\u2019s arteries. This stops blood flow through the artery and damages brain cells. Heart conditions and blood disorders also can cause blood clots that can lead to a stroke or TIA. For example, atrial fibrillation (A-tre-al fi-bri-LA-shun), or AF, is a common cause of embolic stroke. In AF, the upper chambers of the heart contract in a very fast and irregular way. As a result, some blood pools in the heart. The pooling increases the risk of blood clots forming in the heart chambers. An ischemic stroke or TIA also can occur because of lesions caused by atherosclerosis. These lesions may form in the small arteries of the brain, and they can block blood flow to the brain. Hemorrhagic Stroke Sudden bleeding in the brain can cause a hemorrhagic stroke. The bleeding causes swelling of the brain and increased pressure in the skull. The swelling and pressure damage brain cells and tissues. Examples of conditions that can cause a hemorrhagic stroke include high blood pressure, aneurysms, and arteriovenous (ar-TEER-e-o-VE-nus) malformations (AVMs). \"Blood pressure\" is the force of blood pushing against the walls of the arteries as the heart pumps blood. If blood pressure rises and stays high over time, it can damage the body in many ways. Aneurysms are balloon-like bulges in an artery that can stretch and burst. AVMs are tangles of faulty arteries and veins that can rupture within the brain. High blood pressure can increase the risk of hemorrhagic stroke in people who have aneurysms or AVMs. Certain traits, conditions, and habits can raise your risk of having a stroke or transient ischemic attack (TIA). These traits, conditions, and habits are known as risk factors. The more risk factors you have, the more likely you are to have a stroke. You can treat or control some risk factors, such as high blood pressure and smoking. Other risk factors, such as age and gender, you can\u2019t control. The major risk factors for stroke include: High blood pressure. High blood pressure is the main risk factor for stroke. Blood pressure is considered high if it stays at or above 140/90 millimeters of mercury (mmHg) over time. If you have diabetes or chronic kidney disease, high blood pressure is defined as 130/80 mmHg or higher. Diabetes. Diabetes is a disease in which the blood sugar level is high because the body doesn\u2019t make enough insulin or doesn\u2019t use its insulin properly. Insulin is a hormone that helps move blood sugar into cells where it\u2019s used for energy. Heart diseases.\u00a0Coronary heart disease,\u00a0cardiomyopathy,\u00a0heart failure, and\u00a0atrial fibrillation\u00a0can cause blood clots that can lead to a stroke. Smoking. Smoking can damage blood vessels and raise blood pressure. Smoking also may reduce the amount of oxygen that reaches your body\u2019s tissues. Exposure to secondhand smoke also can damage the blood vessels. Age and gender. Your risk of stroke increases as you get older. At younger ages, men are more likely than women to have strokes. However, women are more likely to die from strokes. Women who take birth control pills also are at slightly higher risk of stroke. Race and ethnicity. Strokes occur more often in African American, Alaska Native, and American Indian adults than in white, Hispanic, or Asian American adults. Personal or family history of stroke or TIA. If you\u2019ve had a stroke, you\u2019re at higher risk for another one. Your risk of having a repeat stroke is the highest right after a stroke. A TIA also increases your risk of having a stroke, as does having a family history of stroke. Brain\u00a0aneurysms\u00a0or arteriovenous malformations (AVMs). Aneurysms are balloon-like bulges in an artery that can stretch and burst. AVMs are tangles of faulty arteries and veins that can rupture (break open) within the brain. AVMs may be present at birth, but often aren\u2019t diagnosed until they rupture. Other risk factors for stroke, many of which of you can control, include: Alcohol and illegal drug use, including cocaine, amphetamines, and other drugs Certain medical conditions, such as sickle cell disease, vasculitis (inflammation of the blood vessels), and bleeding disorders Lack of physical activity Overweight and Obesity Stress and depression Unhealthy cholesterol levels Unhealthy diet Use of nonsteroidal anti-inflammatory drugs (NSAIDs), but not aspirin, may increase the risk of heart attack or stroke, particularly in patients who have had a heart attack or cardiac bypass surgery. The risk may increase the longer NSAIDs are used. Common NSAIDs include ibuprofen and naproxen. Following a heart-healthy lifestyle can lower the risk of stroke. Some people also may need to take medicines to lower their risk. Sometimes strokes can occur in people who don\u2019t have any known risk factors. The signs and symptoms of a stroke often develop quickly. However, they can develop over hours or even days. The type of symptoms depends on the type of stroke and the area of the brain that\u2019s affected. How long symptoms last and how severe they are vary among different people. Signs and symptoms of a stroke may include: Sudden weakness Paralysis (an inability to move) or numbness of the face, arms, or legs, especially on one side of the body Confusion Trouble speaking or understanding speech Trouble seeing in one or both eyes Problems breathing Dizziness, trouble walking, loss of balance or coordination, and unexplained falls Loss of consciousness Sudden and severe headache A transient ischemic attack (TIA) has the same signs and symptoms as a stroke. However, TIA symptoms usually last less than 1\u20132 hours (although they may last up to 24 hours). A TIA may occur only once in a person\u2019s lifetime or more often. At first, it may not be possible to tell whether someone is having a TIA or stroke. All stroke-like symptoms require medical care. If you think you or someone else is having a TIA or stroke, call 9\u20131\u20131 right away. Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin life-saving treatment on the way to the emergency room. During a stroke, every minute counts. Stroke Complications After you\u2019ve had a stroke, you may develop other complications, such as: Blood clots and muscle weakness. Being immobile (unable to move around) for a long time can raise your risk of developing blood clots in the deep veins of the legs. Being immobile also can lead to muscle weakness and decreased muscle flexibility. Problems swallowing and pneumonia. If a stroke affects the muscles used for swallowing, you may have a hard time eating or drinking. You also may be at risk of inhaling food or drink into your lungs. If this happens, you may develop pneumonia. Loss of bladder control. Some strokes affect the muscles used to urinate. You may need a urinary catheter (a tube placed into the bladder) until you can urinate on your own. Use of these catheters can lead to urinary tract infections. Loss of bowel control or constipation also may occur after a stroke. Your doctor will diagnose a stroke based on your signs and symptoms, your medical history, a physical exam, and test results. Your doctor will want to find out the type of stroke you\u2019ve had, its cause, the part of the brain that's affected, and whether you have bleeding in the brain. If your doctor thinks you\u2019ve had a transient ischemic attack (TIA), he or she will look for its cause to help prevent a future stroke. Medical History and Physical Exam Your doctor will ask you or a family member about your risk factors for stroke. Examples of risk factors include high blood pressure, smoking, heart disease, and a personal or family history of stroke. Your doctor also will ask about your signs and symptoms and when they began. During the physical exam, your doctor will check your mental alertness and your coordination and balance. He or she will check for numbness or weakness in your face, arms, and legs; confusion; and trouble speaking and seeing clearly. Your doctor will look for signs of carotid artery disease, a common cause of ischemic stroke. He or she will listen to your carotid arteries with a stethoscope. A whooshing sound called a bruit (broo-E) may suggest changed or reduced blood flow due to plaque buildup in the carotid arteries. Diagnostic Tests and Procedures Your doctor may recommend one or more of the following tests to diagnose a stroke or TIA. Brain Computed Tomography A brain computed tomography (to-MOG-rah-fee) scan, or brain CT scan, is a painless test that uses x rays to take clear, detailed pictures of your brain. This test often is done right after a stroke is suspected. A brain CT scan can show bleeding in the brain or damage to the brain cells from a stroke. The test also can show other brain conditions that may be causing your symptoms. Magnetic Resonance Imaging Magnetic resonance imaging (MRI) uses magnets and radio waves to create pictures of the organs and structures in your body. This test can detect changes in brain tissue and damage to brain cells from a stroke. An MRI may be used instead of, or in addition to, a CT scan to diagnose a stroke. Computed Tomography Arteriogram and Magnetic Resonance Arteriogram A CT arteriogram (CTA) and magnetic resonance arteriogram (MRA) can show the large blood vessels in the brain. These tests may give your doctor more information about the site of a blood clot and the flow of blood through your brain. Carotid Ultrasound Carotid ultrasound is a painless and harmless test that uses sound waves to create pictures of the insides of your carotid arteries. These arteries supply oxygen-rich blood to your brain. Carotid ultrasound shows whether plaque has narrowed or blocked your carotid arteries. Your carotid ultrasound test may include a Doppler ultrasound. Doppler ultrasound is a special test that shows the speed and direction of blood moving through your blood vessels. Carotid Angiography Carotid angiography (an-jee-OG-ra-fee) is a test that uses dye and special x rays to show the insides of your carotid arteries. For this test, a small tube called a catheter is put into an artery, usually in the groin (upper thigh). The tube is then moved up into one of your carotid arteries. Your doctor will inject a substance (called contrast dye) into the carotid artery. The dye helps make the artery visible on x-ray pictures. Heart Tests EKG (Electrocardiogram) An EKG is a simple, painless test that records the heart's electrical activity. The test shows how fast the heart is beating and its rhythm (steady or irregular). An EKG also records the strength and timing of electrical signals as they pass through each part of the heart. An EKG can help detect heart problems that may have led to a stroke. For example, the test can help diagnose atrial fibrillation or a previous heart attack. Echocardiography Echocardiography (EK-o-kar-de-OG-ra-fee), or echo, is a painless test that uses sound waves to create pictures of your heart. The test gives information about the size and shape of your heart and how well your heart's chambers and valves are working. Echo can detect possible blood clots inside the heart and problems with the aorta. The aorta is the main artery that carries oxygen-rich blood from your heart to all parts of your body. Blood Tests Your doctor also may use blood tests to help diagnose a stroke. A blood glucose test measures the amount of glucose (sugar) in your blood. Low blood glucose levels may cause symptoms similar to those of a stroke. A platelet count measures the number of platelets in your blood. Blood platelets are cell fragments that help your blood clot. Abnormal platelet levels may be a sign of a bleeding disorder (not enough clotting) or a thrombotic disorder (too much clotting). Your doctor also may recommend blood tests to measure how long it takes for your blood to clot. Two tests that may be used are called PT and PTT tests. These tests show whether your blood is clotting normally. Treatment for a stroke depends on whether it is ischemic or hemorrhagic. Treatment for a transient ischemic attack (TIA) depends on its cause, how much time has passed since symptoms began, and whether you have other medical conditions. Strokes and TIAs are medical emergencies. If you have stroke symptoms, call 9\u20131\u20131 right away. Do not drive to the hospital or let someone else drive you. Call an ambulance so that medical personnel can begin lifesaving treatment on the way to the emergency room. During a stroke, every minute counts. Once you receive immediate treatment, your doctor will try to treat your stroke risk factors and prevent complications by recommending heart-healthy lifestyle changes. Treating an Ischemic Stroke or Transient Ischemic Attack An ischemic stroke or TIA occurs if an artery that supplies oxygen-rich blood to the brain becomes blocked. Often, blood clots cause the blockages that lead to ischemic strokes and TIAs. Treatment for an ischemic stroke or TIA may include medicines and medical procedures. Medicines If you have a stroke caused by a blood clot, you may be given a clot-dissolving, or clot-busting, medication called tissue plasminogen activator (tPA). A doctor will inject tPA into a vein in your arm. This type of medication must be given within 4\u00a0hours of symptom onset. Ideally, it should be given as soon as possible. The sooner treatment begins, the better your chances of recovery. Thus, it\u2019s important to know the signs and symptoms of a stroke and to call 9\u20131\u20131 right away for emergency care. If you can\u2019t have tPA for medical reasons, your doctor may give you antiplatelet medicine that helps stop platelets from clumping together to form blood clots or anticoagulant medicine (blood thinner) that keeps existing blood clots from getting larger. Two common medicines are aspirin and clopidogrel. Medical Procedures If you have carotid artery disease, your doctor may recommend a carotid endarterectomy or carotid artery\u00a0angioplasty. Both procedures open blocked carotid arteries. Researchers are testing other treatments for ischemic stroke, such as intra-arterial thrombolysis and mechanical clot removal in cerebral ischemia (MERCI). In intra-arterial thrombolysis, a long flexible tube called a catheter is put into your groin (upper thigh) and threaded to the tiny arteries of the brain. Your doctor can deliver medicine through this catheter to break up a blood clot in the brain. MERCI is a device that can remove blood clots from an artery. During the procedure, a catheter is threaded through a carotid artery to the affected artery in the brain. The device is then used to pull the blood clot out through the catheter. Treating a Hemorrhagic Stroke A hemorrhagic stroke occurs if an artery in the brain leaks blood or ruptures. The first steps in treating a hemorrhagic stroke are to find the cause of bleeding in the brain and then control it. Unlike ischemic strokes, hemorrhagic strokes aren\u2019t treated with antiplatelet medicines and blood thinners because these medicines can make bleeding worse. If you\u2019re taking antiplatelet medicines or blood thinners and have a hemorrhagic stroke, you\u2019ll be taken off the medicine. If high blood pressure is the cause of bleeding in the brain, your doctor may prescribe medicines to lower your blood pressure. This can help prevent further bleeding. Surgery also may be needed to treat a hemorrhagic stroke. The types of surgery used include aneurysm clipping, coil embolization, and arteriovenous malformation (AVM) repair. Aneurysm Clipping and Coil Embolization If an aneurysm (a balloon-like bulge in an artery) is the cause of a stroke, your doctor may recommend aneurysm clipping or coil embolization. Aneurysm clipping is done to block off the aneurysm from the blood vessels in the brain. This surgery helps prevent further leaking of blood from the aneurysm. It also can help prevent the aneurysm from bursting again.\u00a0During the procedure, a surgeon will make an incision (cut) in the brain and place a tiny clamp at the base of the aneurysm. You\u2019ll be given medicine to make you sleep during the surgery. After the surgery, you\u2019ll need to stay in the hospital\u2019s intensive care unit for a few days. Coil embolization is a less complex procedure for treating an aneurysm. The surgeon will insert a tube called a catheter into an artery in the groin. He or she will thread the tube to the site of the aneurysm.\u00a0Then, a tiny coil will be pushed through the tube and into the aneurysm. The coil will cause a blood clot to form, which will block blood flow through the aneurysm and prevent it from bursting\u00a0again.\u00a0Coil embolization is done in a hospital. You\u2019ll be given medicine to make you sleep during the\u00a0surgery. Arteriovenous Malformation Repair If an AVM is the cause of a stroke, your doctor may recommend an AVM repair. (An AVM is a tangle of faulty arteries and veins that can rupture within the brain.) AVM repair helps prevent further bleeding in the brain. Doctors use several methods to repair AVMs. These methods include: Injecting a substance into the blood vessels of the AVM to block blood flow Surgery to remove the AVM Using radiation to shrink the blood vessels of the AVM Treating Stroke Risk Factors After initial treatment for a stroke or TIA, your doctor will treat your risk factors. He or she may recommend heart-healthy lifestyle changes to help control your risk factors. Heart-healthy lifestyle changes may include: Heart-healthy eating Aiming for a healthy weight Managing stress Physical activity Quitting smoking If heart-healthy lifestyle changes aren\u2019t enough, you may need medicine to control your risk factors. \u00a0 Taking action to control your risk factors can help prevent or delay a stroke. If you\u2019ve already had a stroke.\u00a0Talk to your doctor about whether you may benefit from aspirin\u00a0primary prevention, or using aspirin to help prevent your first stroke. The following heart-healthy lifestyle changes can help prevent your first stroke and help prevent you from having another one. Be physically active. Physical activity can improve your fitness level and health. Talk with your doctor about what types and amounts of activity are safe for you. Don\u2019t smoke, or if you smoke or use tobacco, quit. Smoking can damage and tighten blood vessels and raise your risk of stroke. Talk with your doctor about programs and products that can help you quit. Also, secondhand smoke can damage the blood\u00a0vessels. Aim for a healthy weight. If you\u2019re overweight or obese, work with your doctor to create a reasonable weight loss plan. Controlling your weight helps you control risk factors for stroke. Make heart-healthy eating choices. Heart-healthy eating can help lower your risk or prevent a stroke. Manage stress. Use techniques to lower your stress levels. If you or someone in your family has had a stroke, be sure to tell your doctor. By knowing your family history of stroke, you may be able to lower your risk factors and prevent or delay a stroke. If you\u2019ve had a transient ischemic attack (TIA), don\u2019t ignore it. TIAs are warnings, and it\u2019s important for your doctor to find the cause of the TIA so you can take steps to prevent a stroke. \u00a0 The time it takes to recover from a stroke varies\u2014it can take weeks, months, or even years. Some people recover fully, while others have long-term or lifelong disabilities. Ongoing care, rehabilitation, and emotional support can help you recover and may even help prevent another stroke. If you\u2019ve had a stroke, you\u2019re at risk of having another one. Know the warning signs and what to do if a stroke or transient ischemic attack (TIA) occurs. Call 9\u20131\u20131 as soon as symptoms start. Do not drive to the hospital or let someone else drive you. By calling an ambulance, medical personnel can begin lifesaving treatment on the way to the emergency room. During a stroke, every minute counts. Ongoing Care Heart-Healthy Lifestyle Changes Heart-healthy lifestyle changes can help you recover from a stroke and may help prevent another one. Examples of these changes include heart-healthy eating, aiming for a healthy weight, managing stress, physical activity, and quitting smoking. Medicines Your doctor also may prescribe medicines to help you recover from a stroke or control your stroke risk factors. Take all of your medicines as your doctor prescribes. Don\u2019t cut back on the dosage unless your doctor tells you to do so. If you have side effects or other problems related to your medicines, talk with your doctor. Medicines called anticoagulants or blood thinners, which prevent blood clots or keep existing blood clots from getting larger, are the main treatment for people who have known carotid artery disease, which can lead to a stroke. Two common medicines are aspirin and clopidogrel. You\u2019ll likely need routine blood tests to check how well these medicines are working. The most common side effect of blood thinners is bleeding. This happens if the medicine thins your blood too much. This side effect can be life-threatening. Bleeding can occur inside your body cavities (internal bleeding) or from the surface of your skin (external bleeding). Know the warning signs of bleeding so you can get help right away. They include: Blood in your urine, bright red blood in your stools, or black tarry stools Bright red vomit or vomit that looks like coffee grounds Increased menstrual flow Pain in your abdomen or severe pain in your head Unexplained bleeding from the gums and nose Unexplained bruising or tiny red or purple dots on the skin A lot of bleeding after a fall or injury or easy bruising or bleeding also may mean that your blood is too thin. Call your doctor right away if you have any of these signs. If you have severe bleeding, call 9\u20131\u20131. Your doctor also may discuss beginning statin treatment. Doctors recommend statin medications for many people because they help lower or control blood cholesterol levels and decrease the chance for heart attack and stroke. Doctors usually prescribe statins for people who have: Diabetes Heart disease or have had a stroke High LDL cholesterol levels You should still follow a heart-healthy lifestyle, even if you take medicines to control your risk factors for stroke. Take all medicines regularly, as your doctor prescribes. Don\u2019t change the amount of your medicine or skip a dose unless your doctor tells you to. Talk with your doctor about how often you should schedule follow-up visits or tests. These visits and tests can help your doctor monitor your stroke risk factors and adjust your treatment as\u00a0needed. Rehabilitation After a stroke, you may need rehabilitation (rehab) to help you recover. Rehab may include working with speech, physical, and occupational therapists. Language, Speech, and Memory You may have trouble communicating after a stroke. You may not be able to find the right words, put complete sentences together, or put words together in a way that makes sense. You also may have problems with your memory and thinking clearly. These problems can be very frustrating. Speech and language therapists can help you learn ways to communicate again and improve your memory. Muscle and Nerve Problems A stroke may affect only one side of the body or part of one side. It can cause paralysis (an inability to move) or muscle weakness, which can put you at risk for falling. Physical and occupational therapists can help you strengthen and stretch your muscles. They also can help you relearn how to do daily activities, such as dressing, eating, and bathing. Bladder and Bowel Problems A stroke can affect the muscles and nerves that control the bladder and bowels. You may feel like you have to urinate often, even if your bladder isn\u2019t full. You may not be able to get to the bathroom in time. Medicines and a bladder or bowel specialist can help with these problems. Swallowing and Eating Problems You may have trouble swallowing after a stroke. Signs of this problem are coughing or choking during eating or coughing up food after eating. A speech therapist can help you with these issues. He or she may suggest changes to your diet, such as eating pur\u00e9ed (finely chopped) foods or drinking thick liquids. Mental Health Care and Support After a stroke, you may have changes in your behavior or judgment. For example, your mood may change quickly. Because of these and other changes, you may feel scared, anxious, and depressed. Recovering from a stroke can be slow and frustrating. Talk about how you feel with your health care team. Talking to a professional counselor also can help. If you\u2019re very depressed, your doctor may recommend medicines or other treatments that can improve your quality of life. Joining a patient support group may help you adjust to life after a stroke. You can see how other people have coped with having strokes. Talk with your doctor about local support groups, or check with an area medical center. Support from family and friends also can help relieve fear and anxiety. Let your loved ones know how you feel and what they can do to help you.", @@ -3585,7 +3585,7 @@ ], [ "COPD (Summary): Summary COPD (chronic obstructive pulmonary disease) makes it hard for you to breathe. The two main types are chronic bronchitis and emphysema. The main cause of COPD is long-term exposure to substances that irritate and damage the lungs. This is usually cigarette smoke. Air pollution, chemical fumes, or dust can also cause it. At first, COPD may cause no symptoms or only mild symptoms. As the disease gets worse, symptoms usually become more severe. They include - A cough that produces a lot of mucus - Shortness of breath, especially with physical activity - Wheezing - Chest tightness Doctors use lung function tests, imaging tests, and blood tests to diagnose COPD. There is no cure. Treatments may relieve symptoms. They include medicines, oxygen therapy, surgery, or a lung transplant. Quitting smoking is the most important step you can take to treat COPD. NIH: National Heart, Lung, and Blood Institute", - "#" + NaN ], [ "COPD (More Information): NHLBI resources Alpha-1 Antitrypsin Deficiency Asthma Breathing Better With a COPD Diagnosis\u00a0(also available in\u00a0Spanish) Bronchitis\u00a0 COPD: Are You at Risk?\u00a0(also available in\u00a0Spanish) Chest X Ray Chest CT Scan COPD Learn More Breathe Better\u00ae COPD National Action Plan Cough Fact Sheet:\u00a0Long-Term Oxygen Treatment Trial (LOTT) Frequently Asked Questions How the Lungs Work\u00a0 Lung Transplant Oxygen Therapy\u00a0 Pneumonia Pulmonary Function Tests\u00a0 Pulmonary Rehabilitation\u00a0 Smoking and Your Heart Story of Success: COPD Your Guide to a Healthy Heart Other resources Chronic Bronchitis\u00a0(National Library of Medicine [NLM] MedlinePlus) COPD\u00a0(NLM MedlinePlus) Emphysema\u00a0(NLM MedlinePlus) Smokefree.gov (National Cancer Institute [NCI]) Quitlines and the Expansion of Smoking Cessation Support (NCI) ____________________ \u00ae COPD Learn More Breathe Better is a registered trademark of the U.S. Department of Health and Human Services.", @@ -3721,7 +3721,7 @@ ], [ "Obesity (Summary): Summary Obesity means having too much body fat. It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat, and/or body water. Both terms mean that a person's weight is greater than what's considered healthy for his or her height. Obesity happens over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might affect your weight include your genetic makeup, overeating, eating high-fat foods, and not being physically active. Obesity increases your risk of diabetes, heart disease, stroke, arthritis, and some cancers. If you have obesity, losing even 5 to 10 percent of your weight can delay or prevent some of these diseases. For example, that means losing 10 to 20 pounds if you weigh 200 pounds. NIH: National Institute of Diabetes and Digestive and Kidney Diseases", - "#" + NaN ], [ "Obesity (Possible Complications): Obesity is a major health threat. The extra weight creates many risks to your health.", @@ -3929,7 +3929,7 @@ ], [ "Epilepsy (Summary): Summary Epilepsy is a brain disorder that causes people to have recurring seizures. The seizures happen when clusters of nerve cells, or neurons, in the brain send out the wrong signals. People may have strange sensations and emotions or behave strangely. They may have violent muscle spasms or lose consciousness. Epilepsy has many possible causes, including illness, brain injury, and abnormal brain development. In many cases, the cause is unknown. Doctors use brain scans and other tests to diagnose epilepsy. It is important to start treatment right away. There is no cure for epilepsy, but medicines can control seizures for most people. When medicines are not working well, surgery or implanted devices such as vagus nerve stimulators may help. Special diets can help some children with epilepsy. NIH: National Institute of Neurological Disorders and Stroke", - "#" + NaN ], [ "Epilepsy - resources (Summary): The following organizations are good resources for information on epilepsy: - Epilepsy Foundation -- www.epilepsy.com - National Institute of Neurological Disorders and Stroke -- www.ninds.nih.gov/disorders/epilepsy/epilepsy.htm - US Centers for Disease Control and Prevention -- www.cdc.gov/epilepsy", @@ -4185,11 +4185,11 @@ ], [ "Gonorrhea (More About Gonorrhea): Gonorrhea is a sexually transmitted disease. It is most common in young adults. The bacteria that cause gonorrhea can infect the genital tract, mouth, or anus. You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. A pregnant woman can pass it to her baby during childbirth. Gonorrhea does not always cause symptoms. In men, gonorrhea can cause pain when urinating and discharge from the penis. If untreated, it can cause problems with the prostate and testicles. In women, the early symptoms of gonorrhea often are mild. Later, it can cause bleeding between periods, pain when urinating, and increased discharge from the vagina. If untreated, it can lead to pelvic inflammatory disease, which causes problems with pregnancy and infertility. Your health care provider will diagnose gonorrhea with lab tests. Treatment is with antibiotics. Treating gonorrhea is becoming more difficult because drug-resistant strains are increasing. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading gonorrhea. NIH: National Institute of Allergy and Infectious Diseases", - "https://www.niaid.nih.gov/diseases-conditions/gonorrhea More About Gonorrhea Gonorrhea is a sexually transmitted disease. It is most common in young adults. The bacteria that cause gonorrhea can infect the genital tract, mouth, or anus. You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. A pregnant woman can pass it to her baby during childbirth. Gonorrhea does not always cause symptoms. In men, gonorrhea can cause pain when urinating and discharge from the penis. If untreated, it can cause problems with the prostate and testicles. In women, the early symptoms of gonorrhea often are mild. Later, it can cause bleeding between periods, pain when urinating, and increased discharge from the vagina. If untreated, it can lead to pelvic inflammatory disease, which causes problems with pregnancy and infertility. Your health care provider will diagnose gonorrhea with lab tests. Treatment is with antibiotics. Treating gonorrhea is becoming more difficult because drug-resistant strains are increasing. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading gonorrhea. NIH: National Institute of Allergy and Infectious Diseases" + "https://www.niaid.nih.gov/diseases-conditions/gonorrhea" ], [ "Gonorrhea: Gonorrhea is a sexually transmitted disease that can infect both men and women. Caused by the\u00a0Neisseria gonorrhoeae\u00a0bacterium, gonorrhea can cause infections in the genitals, rectum and throat. Although treatable, drug-resistant forms of gonorrhea are increasing. If left untreated, gonorrhea can lead to pelvic inflammatory disease, ectopic pregnancy, infertility, and increased risk of HIV infection. Gonorrhea can also be passed from mother to child and cause blindness or life-threatening infections in the infant. NIAID supports a comprehensive, multidisciplinary program of research on Neissesria gonorrhoeae (gonococci). Gonorrhea is a sexually transmitted disease. It is most common in young adults. The bacteria that cause gonorrhea can infect the genital tract, mouth, or anus. You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. A pregnant woman can pass it to her baby during childbirth. Gonorrhea does not always cause symptoms. In men, gonorrhea can cause pain when urinating and discharge from the penis. If untreated, it can cause problems with the prostate and testicles. In women, the early symptoms of gonorrhea often are mild. Later, it can cause bleeding between periods, pain when urinating, and increased discharge from the vagina. If untreated, it can lead to pelvic inflammatory disease, which causes problems with pregnancy and infertility. Your health care provider will diagnose gonorrhea with lab tests. Treatment is with antibiotics. Treating gonorrhea is becoming more difficult because drug-resistant strains are increasing. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading gonorrhea. NIH: National Institute of Allergy and Infectious Diseases Scientists have determined the complete genetic code, or sequence (genetic blueprint), of the N. gonorrhoeae genome. They are using this information to help us better understand how the bacterium causes disease and becomes resistant to antibiotics. NIAID also supports research to develop topical microbicides (antimicrobial preparations that can be appled inside the vagina) to prevent gonococcal infections. Another important area of gonorrhea research concerns antibiotic (drug) resistance. This is particularly important because strains of N. gonorhoeae that are resistant to recommended antibiotic treatments have been increasing and are becoming widespread in the United States. These events add urgency to conduct research on and develop new antibiotics and to prevent antibiotic resistance from spreading.", - "https://www.niaid.nih.gov/diseases-conditions/gonorrhea More About Gonorrhea Gonorrhea is a sexually transmitted disease. It is most common in young adults. The bacteria that cause gonorrhea can infect the genital tract, mouth, or anus. You can get gonorrhea during vaginal, oral, or anal sex with an infected partner. A pregnant woman can pass it to her baby during childbirth. Gonorrhea does not always cause symptoms. In men, gonorrhea can cause pain when urinating and discharge from the penis. If untreated, it can cause problems with the prostate and testicles. In women, the early symptoms of gonorrhea often are mild. Later, it can cause bleeding between periods, pain when urinating, and increased discharge from the vagina. If untreated, it can lead to pelvic inflammatory disease, which causes problems with pregnancy and infertility. Your health care provider will diagnose gonorrhea with lab tests. Treatment is with antibiotics. Treating gonorrhea is becoming more difficult because drug-resistant strains are increasing. Correct usage of latex condoms greatly reduces, but does not eliminate, the risk of catching or spreading gonorrhea. NIH: National Institute of Allergy and Infectious Diseases" + "https://www.niaid.nih.gov/diseases-conditions/gonorrhea" ], [ "Gonorrhea (Risk factors): Factors that may increase your risk of gonorrhea infection include: - Younger age - A new sex partner - A sex partner who has concurrent partners - Multiple sex partners - Previous gonorrhea diagnosis - Having other sexually transmitted infections", @@ -4405,7 +4405,7 @@ ], [ "Appendicitis (Summary): Summary The appendix is a small, tube-like organ attached to the first part of the large intestine. It is located in the lower right part of the abdomen. It has no known function. A blockage inside of the appendix causes appendicitis. The blockage leads to increased pressure, problems with blood flow, and inflammation. If the blockage is not treated, the appendix can burst and spread infection into the abdomen. This causes a condition called peritonitis. The main symptom is pain in the abdomen, often on the right side. It is usually sudden and gets worse over time. Other symptoms may include - Swelling in the abdomen - Loss of appetite - Nausea and vomiting - Constipation or diarrhea - Inability to pass gas - Low fever Not everyone with appendicitis has all these symptoms. Appendicitis is a medical emergency. Treatment almost always involves removing the appendix. Anyone can get appendicitis, but it is more common among people 10 to 30 years old. NIH: National Institute of Diabetes and Digestive and Kidney Diseases", - "#" + NaN ], [ "Appendicitis (Treatment): Treating the complications of a burst appendix will depend on the type of complication. In most cases of peritonitis, a surgeon will remove your appendix immediately with surgery. The surgeon will use laparotomy to clean the inside of your abdomen to prevent infection and then remove your appendix. Without prompt treatment, peritonitis can cause death.A surgeon may drain the pus from an appendiceal abscess during surgery or, more commonly, before surgery. To drain an abscess, the surgeon places a tube in the abscess through the abdominal wall. You leave the drainage tube in place for about 2 weeks while you take antibiotics to treat infection. When the infection and inflammation are under control, about 6 to 8 weeks later, surgeons operate to remove what remains of the burst appendix.", @@ -4665,7 +4665,7 @@ ], [ "Ovarian Cancer (Summary): Summary The ovaries are part of the female reproductive system. They produce a woman's eggs and female hormones. Each ovary is about the size and shape of an almond. Cancer of the ovary is not common, but it causes more deaths than other female reproductive cancers. The sooner ovarian cancer is found and treated, the better your chance for recovery. But ovarian cancer is hard to detect early. Women with ovarian cancer may have no symptoms or just mild symptoms until the disease is in an advanced stage. Then it is hard to treat. Symptoms may include - A heavy feeling in the pelvis - Pain in the lower abdomen - Bleeding from the vagina - Weight gain or loss - Abnormal periods - Unexplained back pain that gets worse - Gas, nausea, vomiting, or loss of appetite To diagnose ovarian cancer, doctors do one or more tests. They include a physical exam, a pelvic exam, lab tests, ultrasound, or a biopsy. Treatment is usually surgery followed by chemotherapy. NIH: National Cancer Institute", - "#" + NaN ], [ "Ovarian cancer (Should I be screened for ovarian cancer?): The U.S. Preventive Services Task Force (USPSTF) recommends against screening women who are not at high risk for ovarian cancer. The USPSTF found that testing for ovarian cancer may do more harm than good. Current testing methods, like pelvic exams, ultrasound, and blood tests, can lead to \"false positives\" (results that say a woman has ovarian cancer when she really does not have ovarian cancer). These incorrect results can lead to surgeries that are not needed and that can be risky. Some women, like those who are at high risk, can talk to their doctor about their risk and what they can do to help prevent ovarian cancer.", @@ -5053,7 +5053,7 @@ ], [ "Diabetes Type 2 (Summary): Summary Diabetes means your blood glucose, or blood sugar, levels are too high. With type 2 diabetes, the more common type, your body does not make or use insulin well. Insulin is a hormone that helps glucose get into your cells to give them energy. Without insulin, too much glucose stays in your blood. Over time, high blood glucose can lead to serious problems with your heart, eyes, kidneys, nerves, and gums and teeth. You have a higher risk of type 2 diabetes if you are older, obese, have a family history of diabetes, or do not exercise. Having prediabetes also increases your risk. Prediabetes means that your blood sugar is higher than normal but not high enough to be called diabetes. If you are at risk for type 2 diabetes, you may be able to delay or prevent developing it by making some lifestyle changes. The symptoms of type 2 diabetes appear slowly. Some people do not notice symptoms at all. The symptoms can include - Being very thirsty - Urinating often - Feeling very hungry or tired - Losing weight without trying - Having sores that heal slowly - Having blurry eyesight Blood tests can show if you have diabetes. One type of test, the A1C, can also check on how you are managing your diabetes. Many people can manage their diabetes through healthy eating, physical activity, and blood glucose testing. Some people also need to take diabetes medicines. NIH: National Institute of Diabetes and Digestive and Kidney Diseases", - "#" + NaN ], [ "Diabetes type 2 - meal planning (Summary): When you have type 2 diabetes, taking time to plan your meals goes a long way toward controlling your blood sugar and weight.", @@ -6133,7 +6133,7 @@ ], [ "Multiple Sclerosis (Summary): Summary Multiple sclerosis (MS) is a nervous system disease that affects your brain and spinal cord. It damages the myelin sheath, the material that surrounds and protects your nerve cells. This damage slows down or blocks messages between your brain and your body, leading to the symptoms of MS. They can include - Visual disturbances - Muscle weakness - Trouble with coordination and balance - Sensations such as numbness, prickling, or \"pins and needles\" - Thinking and memory problems No one knows what causes MS. It may be an autoimmune disease, which happens when your immune system attacks healthy cells in your body by mistake. Multiple sclerosis affects women more than men. It often begins between the ages of 20 and 40. Usually, the disease is mild, but some people lose the ability to write, speak, or walk. There is no single test for MS. Doctors use a medical history, physical exam, neurological exam, MRI, and other tests to diagnose it. There is no cure for MS, but medicines may slow it down and help control symptoms. Physical and occupational therapy may also help. NIH: National Institute of Neurological Disorders and Stroke", - "#" + NaN ], [ "Multiple Sclerosis: An unpredictable disease of the central nervous system, multiple sclerosis (MS) can range from relatively benign to somewhat disabling to devastating, as communication between the brain and other parts of the body is disrupted.\u00a0 Many investigators believe MS to be an autoimmune disease -- one in which the body, through its immune system, launches a defensive attack against its own tissues. In the case of MS, it is the nerve-insulating myelin that comes under assault. Such assaults may be linked to an unknown environmental trigger, perhaps a virus. Most people experience their first symptoms of MS between the ages of 20 and 40; the initial symptom of MS is often blurred or double vision, red-green color distortion, or even blindness in one eye.\u00a0 Most MS patients experience muscle weakness in their extremities and difficulty with coordination and balance.\u00a0 These symptoms may be severe enough to impair walking or even standing. In the worst cases, MS can produce partial or complete paralysis.\u00a0 Most people with MS also exhibit paresthesias, transitory abnormal sensory feelings such as numbness, prickling, or \"pins and needles\" sensations.\u00a0 Some may also experience pain.\u00a0 Speech impediments, tremors, and dizziness are other frequent complaints. Occasionally, people with MS have hearing loss. Approximately half of all people with MS experience cognitive impairments such as difficulties with concentration, attention, memory, and poor judgment, but such symptoms are usually mild and are frequently overlooked.\u00a0 Depression is another common feature of MS. Currently there is no cure for MS. Many\u00a0individuals do well with no therapy at all, especially since many medications have serious side effects and some carry significant risks.\u00a0 However, three forms of beta interferon (Avonex, Betaseron, and Rebif) have now been approved by the Food and Drug Administration for treatment of relapsing-remitting MS.\u00a0 The FDA has also approved ocrelizumab (brand name Ocrevus) to treat adults with relapsing forms of MS and primary progressive MS. Beta interferon has been shown to reduce the number of exacerbations and may slow the progression of physical disability. When attacks do occur, they tend to be shorter and less severe.\u00a0 The FDA also has approved a synthetic form of myelin basic protein, called copolymer I (Copaxone), for the treatment of relapsing-remitting MS. Copolymer I has few side effects, and studies indicate that the agent can reduce the relapse rate by almost one third. \u00a0Other FDA approved drugs to treat relapsing forms of MS in adults include teriflunomide and dimethyl fumarate. \u00a0An immunosuppressant treatment,Novantrone\u00a0(mitoxantrone), is\u00a0approved by the FDA for the treatment of advanced or chronic MS. \u00a0The FDA has also approved dalfampridine (Ampyra) to improve walking in individuals with MS. One monoclonal antibody, natalizumab (Tysabri), was shown in clinical trials to significantly reduce the frequency of attacks in people with relapsing forms of MS and was approved for marketing by the U.S. Food and Drug Administration (FDA) in 2004.\u00a0 However, in 2005 the drug\u2019s manufacturer voluntarily suspended marketing of the drug after several reports of significant adverse events.\u00a0 In 2006, the FDA again approved sale of the drug for MS but under strict treatment guidelines involving infusion centers where patients can be monitored by specially trained physicians. \u00a0While steroids do not affect the course of MS over time, they can reduce the duration and severity of attacks in some patients.\u00a0 Spasticity, which can occur either as a sustained stiffness caused by increased muscle tone or as spasms that come and go, is usually treated with muscle relaxants and tranquilizers such as baclofen, tizanidine, diazepam, clonazepam, and dantrolene. Physical therapy and exercise can help preserve remaining function, and patients may find that various aids -- such as foot braces, canes, and walkers -- can help them remain independent and mobile.\u00a0 Avoiding excessive activity and avoiding heat are probably the most important measures patients can take to counter physiological fatigue.\u00a0 If psychological symptoms of fatigue such as depression or apathy are evident, antidepressant medications may help.\u00a0 Other drugs that may reduce fatigue in some, but not all, patients include amantadine (Symmetrel), pemoline (Cylert), and the still-experimental drug aminopyridine. Although improvement of optic symptoms usually occurs even without treatment, a short course of treatment with intravenous methylprednisolone (Solu-Medrol) followed by treatment with oral steroids is sometimes used. A physician may diagnose MS in some patients soon after the onset of the illness. In others, however, doctors may not be able to readily identify the cause of the symptoms, leading to years of uncertainty and multiple diagnoses punctuated by baffling symptoms that mysteriously wax and wane.\u00a0 The vast majority of patients are mildly affected, but in the worst cases, MS can render a person unable to write, speak, or walk.\u00a0 MS is a disease with a natural tendency to remit spontaneously, for which there is no universally effective treatment.", @@ -6345,7 +6345,7 @@ ], [ "Dizziness and Vertigo (Summary): Summary When you're dizzy, you may feel lightheaded, woozy, or disoriented. If you feel like you or the room are spinning, you have vertigo. These feelings may make you lose your balance. Dizziness can have many different causes. A sudden drop in blood pressure or being dehydrated can make you dizzy. Many people feel lightheaded if they get up too quickly from sitting or lying down. Certain medicines and problems with your inner ear may cause dizziness. So can motion sickness. Sometimes dizziness can be a symptom of other disorders. As people get older, they may have more health problems and take more medicines. This makes them more likely to have problems with dizziness and balance. Dizziness usually gets better by itself or is easily treated. If you are dizzy often, you should see your health care provider to find the cause. NIH: National Institutes of Health", - "#" + NaN ], [ "Dehydration (Prevention): To prevent dehydration: - Drink plenty of fluids every day, even when you are well. Drink more when the weather is hot or you are exercising. - If anyone in your family is ill, pay attention to how much they are able to drink. Pay close attention to children and older adults. - Anyone with a fever, vomiting, or diarrhea should drink plenty of fluids. DO NOT wait for signs of dehydration. - If you think you or someone in your family may become dehydrated, call your provider. Do this before the person becomes dehydrated.", @@ -6373,7 +6373,7 @@ ], [ "Dehydration (Summary): Summary When you're dehydrated, your body doesn't have enough fluid and electrolytes to work properly. An average person on an average day needs about 3 quarts of water. But if you're out in the hot sun or are exercising a lot, you need a lot more than that. You can also become dehydrated if you are vomiting, have diarrhea, or are sweating a lot. People who are elderly, very young, taking certain medications, or have a chronic illness have a greater risk. Signs of dehydration in adults include - Being thirsty - Urinating less often than usual - Dark-colored urine - Dry skin - Feeling tired - Dizziness and fainting Signs of dehydration in babies and young children include a dry mouth and tongue, crying without tears, no wet diapers for 3 hours or more, a high fever and being unusually sleepy or drowsy. If you think you're dehydrated, drink small amounts of water over a period of time. Drinking too much all at once can overload your stomach and make you throw up. If you are exercising in the heat and losing a lot of minerals in sweat, sports drinks can be helpful. Avoid any drinks that have caffeine. NIH: National Institutes of Health", - "#" + NaN ], [ "Dehydration (Treatment): The only effective treatment for dehydration is to replace lost fluids and lost electrolytes. The best approach to dehydration treatment depends on age, the severity of dehydration and its cause. For infants and children who have become dehydrated from diarrhea, vomiting or fever, use an over-the-counter oral rehydration solution. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes. Start with about a teaspoon (5 milliliters) every one to five minutes and increase as tolerated. It may be easier to use a syringe for very young children. Older children can be given diluted sports drinks. Use 1 part sports drink to 1 part water. Most adults with mild to moderate dehydration from diarrhea, vomiting or fever can improve their condition by drinking more water or other liquids. Diarrhea may be worsened by full-strength fruit juice and soft drinks. If you work or exercise outdoors during hot or humid weather, cool water is your best bet. Sports drinks containing electrolytes and a carbohydrate solution also may be helpful. Children and adults who are severely dehydrated should be treated by emergency personnel arriving in an ambulance or in a hospital emergency room. Salts and fluids delivered through a vein (intravenously) are absorbed quickly and speed recovery.", @@ -6689,7 +6689,7 @@ ], [ "Drugs and Young People (Summary): Summary Drug abuse is a serious public health problem. It affects almost every community and family in some way. Drug abuse in children and teenagers may pose a greater hazard than in older people. This is because their brains are not yet fully developed. As a result, the brains of young people may be more susceptible to drug abuse and addiction than adult brains. Abused drugs include - Amphetamines - Anabolic steroids - Club drugs - Cocaine - Heroin - Inhalants - Marijuana - Prescription drugs There are different types of treatment for drug abuse. But it is better to prevent drug abuse in the first place. NIH: National Institute on Drug Abuse", - "#" + NaN ], [ "Where to find support for people with Diabetes?: Many resources can help you understand more about diabetes. If you have diabetes, you can also learn ways to manage your condition and prevent diabetes complications.", @@ -6737,7 +6737,7 @@ ], [ "Burns (Summary): Summary A burn is damage to your body's tissues caused by heat, chemicals, electricity, sunlight, or radiation. Scalds from hot liquids and steam, building fires and flammable liquids and gases are the most common causes of burns. Another kind is an inhalation injury, caused by breathing smoke. There are three types of burns: - First-degree burns damage only the outer layer of skin - Second-degree burns damage the outer layer and the layer underneath - Third-degree burns damage or destroy the deepest layer of skin and tissues underneath Burns can cause swelling, blistering, scarring and, in serious cases, shock, and even death. They also can lead to infections because they damage your skin's protective barrier. Treatment for burns depends on the cause of the burn, how deep it is, and how much of the body it covers. Antibiotic creams can prevent or treat infections. For more serious burns, treatment may be needed to clean the wound, replace the skin, and make sure the patient has enough fluids and nutrition. NIH: National Institute of General Medical Sciences", - "#" + NaN ], [ "Burns (Symptoms): Burns don't affect the skin uniformly, so a single injury can reach varying depths. Distinguishing a minor burn from a more serious burn involves determining the extent of tissue damage. The following are three classifications of burns: - First-degree burn. This minor burn affects only the outer layer of the skin (epidermis). It may cause redness, swelling and pain. It usually heals with first-aid measures within several days to a week. Sunburn is a classic example. - Second-degree burn. This type of burn affects both the epidermis and the second layer of skin (dermis). It may cause red, white or splotchy skin, pain, and swelling. And the wound often looks wet or moist. Blisters may develop, and pain can be severe. Deep second-degree burns can cause scarring. - Third-degree burn. This burn reaches into the fat layer beneath the skin. Burned areas may be charred black or white. The skin may look waxy or leathery. Third-degree burns can destroy nerves, causing numbness. A person with this type of burn may also have difficulty breathing or experience smoke inhalation or carbon monoxide poisoning. When to see a doctor Seek emergency medical assistance for: - Burns that cover the hands, feet, face, groin, buttocks, a major joint or a large area of the body - Deep burns, which means burns affecting all layers of the skin and even other tissues - Burns caused by chemicals or electricity - Difficulty breathing or burns to the airway Minor burns can be cared for at home, but call your doctor if you experience: - Large blisters - Signs of infection, such as oozing from the wound, increased pain, redness and swelling - A burn or blister that doesn't heal in several weeks - New, unexplained symptoms - Significant scarring", @@ -6801,7 +6801,7 @@ ], [ "Hepatitis: Hepatitis is an inflammation of the liver. Viruses are the most common cause of hepatitis, but the condition can also be caused by other infections, heavy alcohol use, toxins, certain medications, and autoimmune disease. There are five main virus types that cause hepatitis---type A, B, C, D and E. Hepatitis A and E are typically caused by ingesting contaminated food or water. Type B commonly occurs through contact with infected blood, semen or other bodily fluid through sex, sharing needles or other drug-injection equipment or from mother to baby at birth. Hepatitis type C is a blood-borne virus that is largely spread by sharing needles or other drug injection equipment. Hepatitis D, which is transmitted through contact with infectious blood, occurs only among people with hepatitis B infection. Hepatitis B, C, and D afflict more than half a billion people worldwide and are responsible for more than a million deaths a year. Chronic infection with these viruses can lead to cirrhosis of the liver, end-stage liver disease, and liver cancer. The NIAID Hepatitis Research Program supports research on all hepatitis viruses. However, commensurate with the magnitude of the medical burdens imposed by these viruses, the greatest emphasis is placed on the study of hepatitis C and hepatitis B viruses, which focuses on the understanding the pathogenesis and immunology of hepatitis viruses and developing novel therapeutics and vaccines against diseases caused by hepatitis viruses. Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Hepatitis is an inflammation of the liver. Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; for example, hepatitis A, hepatitis B or hepatitis C. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver. Some people who have hepatitis have no symptoms. Others may have Loss of appetite Nausea and vomiting Diarrhea Dark-colored urine and pale bowel movements Stomach pain Jaundice, yellowing of skin and eyes Some forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer. Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms.", - "https://www.niaid.nih.gov/diseases-conditions/hepatitis More About Hepatitis Your liver is the largest organ inside your body. It helps your body digest food, store energy, and remove poisons. Hepatitis is an inflammation of the liver. Viruses cause most cases of hepatitis. The type of hepatitis is named for the virus that causes it; for example, hepatitis A, hepatitis B or hepatitis C. Drug or alcohol use can also cause hepatitis. In other cases, your body mistakenly attacks healthy cells in the liver. Some people who have hepatitis have no symptoms. Others may have Loss of appetite Nausea and vomiting Diarrhea Dark-colored urine and pale bowel movements Stomach pain Jaundice, yellowing of skin and eyes Some forms of hepatitis are mild, and others can be serious. Some can lead to scarring, called cirrhosis, or to liver cancer. Sometimes hepatitis goes away by itself. If it does not, it can be treated with drugs. Sometimes hepatitis lasts a lifetime. Vaccines can help prevent some viral forms." + "https://www.niaid.nih.gov/diseases-conditions/hepatitis" ], [ "Hepatitis C (What is hepatitis C?): Hepatitis C is a viral infection that causes liver inflammation and damage. Inflammation is swelling that occurs when tissues of the body become injured or infected. Inflammation can damage organs.Viruses invade normal cells in your body. Many viruses cause infections that can be spread from person to person. The hepatitis C virus spreads through contact with an infected person\u2019s blood.Hepatitis C can cause an acute or chronic infection.Although no vaccine for hepatitis C is available, you can take steps to protect yourself from hepatitis C. If you have hepatitis C, talk with your doctor about treatment. Medicines can cure most cases of hepatitis C.Acute hepatitis CAcute hepatitis C is a short-term infection. Symptoms can last up to 6 months. Sometimes your body is able to fight off the infection and the virus goes away.Chronic hepatitis CChronic hepatitis C is a long-lasting infection. Chronic hepatitis C occurs when your body isn\u2019t able to fight off the virus. About 75 to 85 percent of people with acute hepatitis C will develop chronic hepatitis C.13Early diagnosis and treatment of chronic hepatitis C can prevent liver damage. Without treatment, chronic hepatitis C can cause chronic liver disease, cirrhosis, liver failure, or liver cancer.", @@ -6877,7 +6877,7 @@ ], [ "Neuromuscular Disorders (Summary): Summary Neuromuscular disorders affect the nerves that control your voluntary muscles. Voluntary muscles are the ones you can control, like in your arms and legs. Your nerve cells, also called neurons, send the messages that control these muscles. When the neurons become unhealthy or die, communication between your nervous system and muscles breaks down. As a result, your muscles weaken and waste away. The weakness can lead to twitching, cramps, aches and pains, and joint and movement problems. Sometimes it also affects heart function and your ability to breathe. Examples of neuromuscular disorders include - Amyotrophic lateral sclerosis - Multiple sclerosis - Myasthenia gravis - Spinal muscular atrophy Many neuromuscular diseases are genetic, which means they run in families or there is a mutation in your genes. Sometimes, an immune system disorder can cause them. Most of them have no cure. The goal of treatment is to improve symptoms, increase mobility and lengthen life.", - "#" + NaN ], [ "Myasthenia gravis (Summary): Myasthenia gravis is a neuromuscular disorder. Neuromuscular disorders involve the muscles and the nerves that control them.", @@ -7529,7 +7529,7 @@ ], [ "How to Prevent Diabetes (Summary): Summary What is type 2 diabetes? If you have diabetes, your blood sugar levels are too high. With type 2 diabetes, this happens because your body does not make enough insulin, or it does not use insulin well (this is called insulin resistance). If you are at risk for type 2 diabetes, you might be able to prevent or delay developing it. Who is at risk for type 2 diabetes? Many Americans are at risk for type 2 diabetes. Your chances of getting it depend on a combination of risk factors such as your genes and lifestyle. The risk factors include - Having prediabetes, which means you have blood sugar levels that are higher than normal but not high enough to be called diabetes - Being overweight or having obesity - Being age 45 or older - A family history of diabetes - Being African American, Alaska Native, American Indian, Asian American, Hispanic/Latino, Native Hawaiian, or Pacific Islander - Having high blood pressure - Having a low level of HDL (good) cholesterol or a high level of triglycerides - A history of diabetes in pregnancy - Having given birth to a baby weighing 9 pounds or more - An inactive lifestyle - A history of heart disease or stroke - Having depression - Having polycystic ovary syndrome (PCOS) - Having acanthosis nigricans, a skin condition in which your skin becomes dark and thick, especially around your neck or armpits - Smoking How can I prevent or delay getting type 2 diabetes? If you are at risk for diabetes, you may be able to prevent or delay getting it. Most of the things that you need to do involve having a healthier lifestyle. So if you make these changes, you will get other health benefits as well. You may lower your risk of other diseases, and you will probably feel better and have more energy. The changes are - Losing weight and keeping it off. Weight control is an important part of diabetes prevention. You may be able to prevent or delay diabetes by losing 5 to 10 percent of your current weight. For example, if you weigh 200 pounds, your goal would be to lose between 10 to 20 pounds. And once you lose the weight, it is important that you don't gain it back. - Following a healthy eating plan. It is important to reduce the amount of calories you eat and drink each day, so you can lose weight and keep it off. To do that, your diet should include smaller portions and less fat and sugar. You should also eat a variety of foods from each food group, including plenty of whole grains, fruits, and vegetables. It's also a good idea to limit red meat, and avoid processed meats. - Get regular exercise. Exercise has many health benefits, including helping you to lose weight and lower your blood sugar levels. These both lower your risk of type 2 diabetes. Try to get at least 30 minutes of physical activity 5 days a week. If you have not been active, talk with your health care professional to figure out which types of exercise are best for you. You can start slowly and work up to your goal. - Don't smoke. Smoking can contribute to insulin resistance, which can lead to type 2 diabetes. If you already smoke, try to quit. - Talk to your health care provider to see whether there is anything else you can do to delay or to prevent type 2 diabetes. If you are at high risk, your provider may suggest that you take one of a few types of diabetes medicines. NIH: National Institute of Diabetes and Digestive and Kidney Diseases", - "#" + NaN ], [ "How to prevent Type 1 diabetes?: Type 1 diabetes cannot be prevented. There is no screening test for type 1 diabetes in people who have no symptoms.", @@ -8345,7 +8345,7 @@ ], [ "Obsessive-Compulsive Disorder (Summary): Summary Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. If you have OCD, you have frequent, upsetting thoughts called obsessions. To try to control the thoughts, you feel an overwhelming urge to repeat certain rituals or behaviors. These are called compulsions. Examples of obsessions are a fear of germs or a fear of being hurt. Compulsions include washing your hands, counting, checking on things, or cleaning. With OCD, the thoughts and rituals cause distress and get in the way of your daily life. Researchers think brain circuits may not work properly in people who have OCD. It tends to run in families. The symptoms often begin in children or teens. Treatments include therapy, medicines, or both. One type of therapy, cognitive behavioral therapy, is useful for treating OCD. NIH: National Institute of Mental Health", - "#" + NaN ], [ "Obsessive-compulsive disorder (OCD) (Diagnosis): Steps to help diagnose OCD may include: - Physical exam. This may be done to help rule out other problems that could be causing your symptoms and to check for any related complications. - Lab tests. These may include, for example, a complete blood count (CBC), a check of your thyroid function, and screening for alcohol and drugs. - Psychological evaluation. This includes discussing your thoughts, feelings, symptoms and behavior patterns. With your permission, this may include talking to your family or friends. - Diagnostic criteria for OCD. Your doctor may use criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association. Diagnostic challenges It's sometimes difficult to diagnose OCD because symptoms can be similar to those of obsessive-compulsive personality disorder, anxiety disorders, depression, schizophrenia or other mental health disorders. And it's possible to have both OCD and another mental disorder. Work with your doctor so that you can get the appropriate diagnosis and treatment.", @@ -8525,7 +8525,7 @@ ], [ "Chronic Bronchitis (Summary): Summary Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus. It can also cause shortness of breath, wheezing, a low fever, and chest tightness. There are two main types of bronchitis: acute and chronic. Chronic bronchitis is one type of COPD (chronic obstructive pulmonary disease). The inflamed bronchial tubes produce a lot of mucus. This leads to coughing and difficulty breathing. Cigarette smoking is the most common cause. Breathing in air pollution, fumes, or dust over a long period of time may also cause it. To diagnose chronic bronchitis, your doctor will look at your signs and symptoms and listen to your breathing. You may also have other tests. Chronic bronchitis is a long-term condition that keeps coming back or never goes away completely. If you smoke, it is important to quit. Treatment can help with your symptoms. It often includes medicines to open your airways and help clear away mucus. You may also need oxygen therapy. Pulmonary rehabilitation may help you manage better in daily life. NIH: National Heart, Lung, and Blood Institute", - "#" + NaN ], [ "Industrial bronchitis: Industrial bronchitis is swelling (inflammation) of the large airways of the lungs that occurs in some people who work around certain dusts, fumes, smoke, or other substances. Exposure to dusts, fumes, strong acids, and other chemicals in the air causes this type of bronchitis. Smoking may also contribute. You may be at risk if you are exposed to dusts that contain: - Asbestos - Coal - Cotton - Flax - Latex - Metals - Silica - Talc - Toluene diisocyanate - Western red cedar Symptoms may include any of the following: - Cough that brings up mucus (sputum) - Shortness of breath - Wheezing The health care provider will listen to your lungs using a stethoscope. Wheezing sounds or crackles may be heard. Tests that may be ordered include: - Chest CT scan - Chest x-ray - Pulmonary function tests (to measure breathing and how well the lungs are functioning) The goal of treatment is to reduce the irritation. Getting more air into the workplace or wearing masks to filter out the offending dust particles may help. Some people may need to be taken out of the workplace. Some cases of industrial bronchitis go away without treatment. Other times, a person may need inhaled anti-inflammatory medicines. If you are at risk or have experienced this problem and you smoke, stop smoking. Helpful measures include: - Breathing humidified air - Increasing fluid intake - Resting The outcome may be good as long as you can stop being exposed to the irritant. Chronic disability from industrial bronchitis is rare. Continued exposure to irritating gases, fumes, or other substances can lead to permanent lung damage. Call your provider if you are regularly exposed to dusts, fumes, strong acids, or other chemicals that can affect the lungs and you develop symptoms of bronchitis. Control dust in industrial settings by wearing face masks and protective clothing, and by treating textiles. Stop smoking if you are at risk. Get early screening by a doctor if you are exposed to chemicals that can cause this condition. If you think a chemical you work with is affecting your breathing, ask your employer for a copy of the Material Safety Data Sheet. Bring it with you to your provider. Updated by: Denis Hadjiliadis, MD, MHS, Paul F. Harron Jr. Associate Professor of Medicine, Pulmonary, Allergy, and Critical Care, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.", @@ -8565,7 +8565,7 @@ ], [ "Chickenpox (Summary): Summary Chickenpox is an infection caused by the varicella-zoster virus. Most cases are in children under age 15, but older children and adults can get it. It spreads very easily from one person to another. The classic symptom of chickenpox is an uncomfortable, itchy rash. The rash turns into fluid-filled blisters and eventually into scabs. It usually shows up on the face, chest, and back and then spreads to the rest of the body. Other symptoms include - Fever - Headache - Tiredness - Loss of appetite Chickenpox is usually mild and lasts 5 to 10 days. Calamine lotions and oatmeal baths can help with itching. Acetaminophen can treat the fever. Do not use aspirin for chickenpox; that combination can cause Reye syndrome. Chickenpox can sometimes cause serious problems. Adults, babies, teenagers, pregnant women, and those with weak immune systems tend to get sicker from it. They may need to take antiviral medicines. Once you catch chickenpox, the virus usually stays in your body. You probably will not get chickenpox again, but the virus can cause shingles in adults. A chickenpox vaccine can help prevent most cases of chickenpox, or make it less severe if you do get it. Centers for Disease Control and Prevention", - "#" + NaN ], [ "Varicella (Chickenpox) Vaccine (Who should not get chickenpox vaccine or should wait?): - People should not get chickenpox vaccine if they have ever had a life-threatening allergic reaction to gelatin, the antibiotic neomycin, or a previous dose of chickenpox vaccine. - People who are moderately or severely ill at the time the shot is scheduled should usually wait until they recover before getting chickenpox vaccine. - Pregnant women should wait to get chickenpox vaccine until after they have given birth. Women should not get pregnant for 1 month after getting chickenpox vaccine. - Some people should check with their doctor about whether they should get chickenpox vaccine, including anyone who: has HIV/AIDS or another disease that affects the immune system; is being treated with drugs that affect the immune system, such as steroids, for 2 weeks or longer; has any kind of cancer; is getting cancer treatment with radiation or drugs - People who recently had a transfusion or were given other blood products should ask their doctor when they may get chickenpox vaccine.", @@ -8609,7 +8609,7 @@ ], [ "Dengue (Summary): Summary Dengue is an infection caused by a virus. You can get it if an infected mosquito bites you. Dengue does not spread from person to person. It is common in warm, wet areas of the world. Outbreaks occur in the rainy season. Dengue is rare in the United States. Symptoms include a high fever, headaches, joint and muscle pain, vomiting, and a rash. In some cases, dengue turns into dengue hemorrhagic fever, which causes bleeding from your nose, gums, or under your skin. It can also become dengue shock syndrome, which causes massive bleeding and shock. These forms of dengue are life-threatening. There is no specific treatment. Most people with dengue recover within 2 weeks. Until then, drinking lots of fluids, resting and taking non-aspirin fever-reducing medicines might help. People with the more severe forms of dengue usually need to go to the hospital and get fluids. To lower your risk when traveling to areas where dengue is found - Wear insect repellent with DEET - Wear clothes that cover your arms, legs and feet - Close unscreened doors and windows NIH: National Institute of Allergy and Infectious Diseases", - "#" + NaN ], [ "How to prevent Dengue fever?: Clothing, mosquito repellent, and netting can help reduce the risk of mosquito bites that can spread dengue fever and other infections. Limit outdoor activity during mosquito season, especially when they are most active, at dawn and dusk.", @@ -8621,7 +8621,7 @@ ], [ "Dengue Fever: Dengue fever is an infectious disease carried by mosquitoes and caused by any of four related dengue viruses. This disease used to be called \"break-bone\" fever because it sometimes causes severe joint and muscle pain that feels like bones are breaking. Health experts have known about dengue fever for more than 200 years.\u00a0 Worldwide, about 50 million cases of dengue infection occur each year, with 22,000 deaths, mostly in children. This includes 100 to 200 cases in the United States, mostly in people who have recently traveled abroad. Many more cases likely go unreported because some healthcare providers do not recognize the disease. In the Western hemisphere, the estimated economic burden of dengue is about $2.1 billion per year. Recognizing the threat to public health posed by dengue, NIAID is funding nearly 60 dengue research projects, including studies on dengue hemorrhagic fever and dengue shock syndrome, the most severe forms of the disease. NIAID research priorities include effective community-based prevention programs, improved laboratory-based international surveillance, rapid diagnostic tests and therapies, and development of and clinical trials for dengue vaccines. Dengue is an infection caused by a virus. You can get it if an infected mosquito bites you. Dengue does not spread from person to person. It is common in warm, wet areas of the world. Outbreaks occur in the rainy season. Dengue is rare in the United States. Symptoms include a high fever, headaches, joint and muscle pain, vomiting, and a rash. In some cases, dengue turns into dengue hemorrhagic fever, which causes bleeding from your nose, gums, or under your skin. It can also become dengue shock syndrome, which causes massive bleeding and shock. These forms of dengue are life-threatening. There is no specific treatment. Most people with dengue recover within 2 weeks. Until then, drinking lots of fluids, resting and taking non-aspirin fever-reducing medicines might help. People with the more severe forms of dengue usually need to go to the hospital and get fluids. To lower your risk when traveling to areas where dengue is found Wear insect repellent with DEET Wear clothes that cover your arms, legs and feet Close unscreened doors and windows NIH: National Institute of Allergy and Infectious Diseases Dengue has emerged as a global health threat, while scientists still know little about how the virus infects cells and causes the disease. To answer these questions, NIAID supports a wide-range of basic research activities aimed at better understanding the biology of the dengue virus, the progression of disease in infected people, and the interactions between the virus and the immune system. New research findings are shedding light on the mechanisms of dengue infection, such as how the virus enters the cells and how the human immune system responds to dengue infection. Other NIAID projects are identifying the human and viral factors that determine and contribute to the severity and transmissibility of this disease. NIAID researchers are actively engaged in the search for an effective vaccine against dengue fever. The vaccine approach that is currently been evaluated at NIAID for efficacy against dengue animal models and human trials is a weakened recombinant version (live-attenuated) of the dengue virus. Other NIAID-funded investigators are working to develop dengue vaccines using different live-attenuated dengue viruses, recombinant proteins, viral vectors, and DNA. NIAID-supported scientists are working to understand the pathology of\u00a0dengue disease and to develop cost-effective, sensitive, and specific diagnostic tests for use in dengue-endemic countries. The goal of these tests is to provide early detection of the disease, distinguish between the different viral dengue, and predict which\u00a0people are at highest risk of developing the more severe forms of the disease, dengue hemorrhagic fever and dengue shock syndrome. Quick and effective diagnosis of dengue is critical to effectively control outbreaks, treat the disease, and reduce mortality. In one project supported by NIAID, researchers are developing an automated, portable, point-of-care machine for rapid dengue diagnosis\u00a0 NIAID-supported investigators are pursuing several approaches to treat dengue infection. Some scientists are working to identify cellular and viral proteins to use as targets for drug intervention. In other studies, researchers are generating and evaluating neutralizing monoclonal antibodies and small molecule drugs in animal models. Results from these animal trials may result in new treatment options for people with dengue. In one NIAID-funded contract, researchers evaluated about 7,500 antiviral compounds\u00a0in vitro\u00a0to test their efficacy against dengue. So far, 49 have been identified for further evaluation.", - "https://www.niaid.nih.gov/diseases-conditions/dengue-fever More About Dengue Fever Dengue is an infection caused by a virus. You can get it if an infected mosquito bites you. Dengue does not spread from person to person. It is common in warm, wet areas of the world. Outbreaks occur in the rainy season. Dengue is rare in the United States. Symptoms include a high fever, headaches, joint and muscle pain, vomiting, and a rash. In some cases, dengue turns into dengue hemorrhagic fever, which causes bleeding from your nose, gums, or under your skin. It can also become dengue shock syndrome, which causes massive bleeding and shock. These forms of dengue are life-threatening. There is no specific treatment. Most people with dengue recover within 2 weeks. Until then, drinking lots of fluids, resting and taking non-aspirin fever-reducing medicines might help. People with the more severe forms of dengue usually need to go to the hospital and get fluids. To lower your risk when traveling to areas where dengue is found Wear insect repellent with DEET Wear clothes that cover your arms, legs and feet Close unscreened doors and windows NIH: National Institute of Allergy and Infectious Diseases" + "https://www.niaid.nih.gov/diseases-conditions/dengue-fever" ], [ "Dengue fever (Symptoms): Many people, especially children and teens, may experience no signs or symptoms during a mild case of dengue fever. When symptoms do occur, they usually begin four to seven days after you are bitten by an infected mosquito. Dengue fever causes a high fever - 104 F degrees - and at least two of the following symptoms: - Headache - Muscle, bone and joint pain - Nausea - Vomiting - Pain behind the eyes - Swollen glands - Rash Most people recover within a week or so. In some cases, symptoms worsen and can become life-threatening. Blood vessels often become damaged and leaky. And the number of clot-forming cells (platelets) in your bloodstream drops. This can cause a severe form of dengue fever, called dengue hemorrhagic fever, severe dengue or dengue shock syndrome. Signs and symptoms of dengue hemorrhagic fever or severe dengue - a life-threatening emergency - include: - Severe abdominal pain - Persistent vomiting - Bleeding from your gums or nose - Blood in your urine, stools or vomit - Bleeding under the skin, which might look like bruising - Difficult or rapid breathing - Cold or clammy skin (shock) - Fatigue - Irritability or restlessness When to see a doctor Call 911 or go to the nearest emergency room if you've recently visited a region in which dengue fever is known to occur and you develop emergency symptoms, such as severe abdominal pain, vomiting, difficulty breathing, or blood in your nose, gums, vomit or stools. If you develop a fever and milder symptoms common to dengue fever, call your doctor.", @@ -8629,7 +8629,7 @@ ], [ "Dengue Fever (Diagnosis): NIAID-supported scientists are working to understand the pathology of\u00a0dengue disease and to develop cost-effective, sensitive, and specific diagnostic tests for use in dengue-endemic countries. The goal of these tests is to provide early detection of the disease, distinguish between the different viral dengue, and predict which\u00a0people are at highest risk of developing the more severe forms of the disease, dengue hemorrhagic fever and dengue shock syndrome. Quick and effective diagnosis of dengue is critical to effectively control outbreaks, treat the disease, and reduce mortality. In one project supported by NIAID, researchers are developing an automated, portable, point-of-care machine for rapid dengue diagnosis", - "https://www.niaid.nih.gov/diseases-conditions/dengue-fever More About Dengue Fever Dengue is an infection caused by a virus. You can get it if an infected mosquito bites you. Dengue does not spread from person to person. It is common in warm, wet areas of the world. Outbreaks occur in the rainy season. Dengue is rare in the United States. Symptoms include a high fever, headaches, joint and muscle pain, vomiting, and a rash. In some cases, dengue turns into dengue hemorrhagic fever, which causes bleeding from your nose, gums, or under your skin. It can also become dengue shock syndrome, which causes massive bleeding and shock. These forms of dengue are life-threatening. There is no specific treatment. Most people with dengue recover within 2 weeks. Until then, drinking lots of fluids, resting and taking non-aspirin fever-reducing medicines might help. People with the more severe forms of dengue usually need to go to the hospital and get fluids. To lower your risk when traveling to areas where dengue is found Wear insect repellent with DEET Wear clothes that cover your arms, legs and feet Close unscreened doors and windows NIH: National Institute of Allergy and Infectious Diseases" + "https://www.niaid.nih.gov/diseases-conditions/dengue-fever" ], [ "Dengue fever (Summary): The following summary is from Orphanet, a European reference portal for information on rare diseases and orphan drugs. Orpha Number: 99828 Disease definition Dengue fever (DF), caused by dengue virus , is an arboviral disease characterized by an initial non-specific febrile illness that can sometimes progress to more severe forms manifesting capillary leakage and hemorrhage (dengue hemorrhagic fever, or DHF) and shock (dengue shock syndrome , or DSS). Epidemiology DF is found in the tropics worldwide, especially in Southeast Asia, the Pacific region, and the Americas, with 40% of the global population at risk. An estimated 50 to 100 million cases of DF, 500,000 hospitalizations, and 20,000 deaths occur yearly worldwide. Clinical description The vast majority of dengue virus infections result in DF, which is characterized by sudden onset of fever, malaise, headache (classically retro-orbital), and myalgia/arthralgia, often followed soon after by a petechial rash, which may be pruritic. In most cases, symptoms will resolve within 7 days without further complications. However, in a small minority of patients, a brief period of deffervescence is followed by worsening abdominal symptoms (pain, nausea, vomiting, diarrhea), thrombocytopenia , hemorrhage (DHF: epistaxis, bleeding gums, gastrointestinal bleeding) and a capillary leak syndrome (DSS: hemoconcentration, hypoalbuminemia, pleural effusion, shock). DHF/DSS are seen most often in children under the age of 15 years. Risk is greater with secondary heterologous infection by one of the four dengue virus serotypes, but severe disease may be seen with first infections. Etiology Over 25 different viruses cause viral hemorrhagic fever. Dengue virus belongs to the Flaviviridae family, genus Flavivirus. Four distinct serotypes, with significant strain variation, are recognized. Dengue viruses are maintained in humans and transmitted between them by the bite of infected mosquitoes, most commonly Aedes aegypti but also Aedes albopictus). Person-to-person transmission has not been reported. Diagnostic methods Common diagnostic modalities include serologic testing by enzyme linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT-PCR). Virus isolation may also be performed in specialized laboratories. The viremic phase of DF/DHF is usually brief (first 3-5 days of illness), after which time detection of anti-dengue IgM antibodies , which appear as early as 2-4 days after disease onset, is the mainstay. Numerous commercial ELISA assays are available with varying degrees of sensitivity and specificity. Differential diagnosis DF is difficult to distinguish from a host of other febrile illnesses such as malaria and typhoid fever (see these terms), especially early in the course of disease before the rash appears. For DHF/DSS, other viral hemorrhagic fevers, leptospirosis, rickettsial infection (see these terms) and meningococcemia need to be excluded. Management and treatment As there is presently no antiviral drug available for DF/DHF, treatment is supportive, following the guidelines for treatment of severe septicemia. Insecticide-treated bed nets, room screens and elimination of larval development sites should be used in open-air settings to prevent further transmission. Prognosis Case-fatality rates for DF are less than 1% but may rise to as high as 40% in DHF/DSS, largely dependent upon whether access to advanced medical care exists. Children and persons with underlying chronic diseases such as diabetes, heart disease, and asthma are at increased risk. The most severe phase of disease usually lasts only a few days and survivors generally have no lasting sequelae. Visit the Orphanet disease page for more resources.", @@ -8701,11 +8701,11 @@ ], [ "Staphylococcal Infections (Summary): Summary Staph is short for Staphylococcus, a type of bacteria. There are over 30 types, but Staphylococcus aureus causes most staph infections (pronounced \"staff infections\"), including - Skin infections - Pneumonia - Food poisoning - Toxic shock syndrome - Blood poisoning (bacteremia) Skin infections are the most common. They can look like pimples or boils. They may be red, swollen and painful, and sometimes have pus or other drainage. They can turn into impetigo, which turns into a crust on the skin, or cellulitis, a swollen, red area of skin that feels hot. Anyone can get a staph skin infection. You are more likely to get one if you have a cut or scratch, or have contact with a person or surface that has staph bacteria. The best way to prevent staph is to keep hands and wounds clean. Most staph skin infections are easily treated with antibiotics or by draining the infection. Some staph bacteria such as MRSA (methicillin-resistant Staphylococcus aureus) are resistant to certain antibiotics, making infections harder to treat.", - "#" + NaN ], [ "Tetanus (Summary): Summary Tetanus is a serious illness caused by Clostridium bacteria. The bacteria live in soil, saliva, dust, and manure. The bacteria can enter the body through a deep cut, like those you might get from stepping on a nail, or through a burn. The infection causes painful tightening of the muscles, usually all over the body. It can lead to \"locking\" of the jaw. This makes it impossible to open your mouth or swallow. Tetanus is a medical emergency. You need to get treatment in a hospital. A vaccine can prevent tetanus. It is given as a part of routine childhood immunization. Adults should get a tetanus shot, or booster, every 10 years. If you get a bad cut or burn, see your doctor - you may need a booster. Immediate and proper wound care can prevent tetanus infection.", - "#" + NaN ], [ "What is Tetanus?: Tetanus is aninfection of the nervous system with a type of bacteria that is potentially deadly, called Clostridium tetani (C. tetani).", @@ -8873,7 +8873,7 @@ ], [ "Lice (Summary): Summary Lice are parasitic insects that can be found on people's heads and bodies. They survive by feeding on human blood. Lice found on each area of the body are different from each other. The three types of lice that live on humans are head lice, body lice (also called clothes lice), and pubic lice (\"crabs\"). Symptoms of lice may include - Intense itching - Rash - Visible nits (lice eggs) or crawling lice Lice spread most commonly by close person-to-person contact. Dogs, cats, and other pets do not spread human lice. Lice move by crawling. They cannot hop or fly. If you get lice, both over-the-counter and prescription medicines are available for treatment. Centers for Disease Control and Prevention", - "#" + NaN ], [ "Body lice (Risk factors): People who are at higher risk of body lice tend to live in crowded, unclean conditions. They include: - War refugees - Homeless people - Victims of natural disasters Dogs, cats and other pets do not spread body lice.", @@ -9305,7 +9305,7 @@ ], [ "Snoring (Summary): Summary Snoring is the sound you make when your breathing is blocked while you are asleep. The sound is caused by tissues at the top of your airway that strike each other and vibrate. Snoring is common, especially among older people and people who are overweight. When severe, snoring can cause frequent awakenings at night and daytime sleepiness. It can disrupt your bed partner's sleep. Snoring can also be a sign of a serious sleep disorder called sleep apnea. You should see your health care provider if you are often tired during the day, don't feel that you sleep well, or wake up gasping. To reduce snoring - Lose weight if you are overweight. It may help, but thin people can snore, too. - Cut down or avoid alcohol and other sedatives at bedtime - Don't sleep flat on your back NIH: National Institute on Aging", - "#" + NaN ], [ "Snoring (Risk factors): Risk factors that may contribute to snoring include: - Being a man. Men are more likely to snore or have sleep apnea than are women. - Being overweight. People who are overweight or obese are more likely to snore or have obstructive sleep apnea. - Having a narrow airway. Some people may have a long soft palate, or large tonsils or adenoids, which can narrow the airway and cause snoring. - Drinking alcohol. Alcohol relaxes your throat muscles, increasing the risk of snoring. - Having nasal problems. If you have a structural defect in your airway, such as a deviated septum, or your nose is chronically congested, your risk of snoring is greater. - Having a family history of snoring or obstructive sleep apnea. Heredity is a potential risk factor for OSA.",